Healthcare Provider Details

I. General information

NPI: 1154426864
Provider Name (Legal Business Name): ANNIE MARIE POWELL-WILLIAMS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E RIVER PL STE 100
JACKSON MS
39202-3402
US

IV. Provider business mailing address

206 SIMMONS DRIVE EXT
CALHOUN CITY MS
38916-9522
US

V. Phone/Fax

Practice location:
  • Phone: 769-251-5550
  • Fax: 662-728-9803
Mailing address:
  • Phone: 662-927-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: