Healthcare Provider Details

I. General information

NPI: 1427747443
Provider Name (Legal Business Name): TAMI ALEXANDRIA WILLIAMS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 GROVE AVE STE 216
CEDARHURST NY
11516-2302
US

IV. Provider business mailing address

67 SAINT MARKS AVE
FREEPORT NY
11520-5407
US

V. Phone/Fax

Practice location:
  • Phone: 516-350-8564
  • Fax:
Mailing address:
  • Phone: 347-631-5857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: