Healthcare Provider Details

I. General information

NPI: 1003177189
Provider Name (Legal Business Name): PATRICIA ANNE WILLIAMS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 06/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GARRISON BLVD SIOTE 200
BALTIMORE MD
21216
US

IV. Provider business mailing address

2901 1/2 LINWOOD AVE
PARKVILLE MD
21234-5632
US

V. Phone/Fax

Practice location:
  • Phone: 410-233-3111
  • Fax: 410-233-3222
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number07823
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: