Healthcare Provider Details

I. General information

NPI: 1336386846
Provider Name (Legal Business Name): JENNIFER LYNN WILLIAMS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44725 GRAND RIVER AVE STE 104
NOVI MI
48375-1024
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 517-492-0784
  • Fax:
Mailing address:
  • Phone: 517-492-0784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801106635
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: