Healthcare Provider Details

I. General information

NPI: 1558133256
Provider Name (Legal Business Name): LYNN WILLIAMS LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1841 N PERRY ST
PONTIAC MI
48340-2235
US

IV. Provider business mailing address

56811 FOXCROFT CT
SHELBY TOWNSHIP MI
48316-4818
US

V. Phone/Fax

Practice location:
  • Phone: 248-745-4900
  • Fax:
Mailing address:
  • Phone: 586-781-6144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851114664
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: