Healthcare Provider Details

I. General information

NPI: 1225961436
Provider Name (Legal Business Name): TIARA WILLIAMS LICSW, LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2494 RIVA RD APT 2504
ANNAPOLIS MD
21401-7799
US

IV. Provider business mailing address

2494 RIVA RD APT 2504
ANNAPOLIS MD
21401-7799
US

V. Phone/Fax

Practice location:
  • Phone: 667-500-4308
  • Fax:
Mailing address:
  • Phone: 667-500-4308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200003820
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23693
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: