Healthcare Provider Details

I. General information

NPI: 1790612588
Provider Name (Legal Business Name): ALIYAH A WILLIAMS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

362 DEVOE AVE UNIT 473
BRONX NY
10460-9448
US

IV. Provider business mailing address

10169 S WINSTON AVE
CHICAGO IL
60643-1356
US

V. Phone/Fax

Practice location:
  • Phone: 708-262-7219
  • Fax:
Mailing address:
  • Phone: 708-262-7219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: