Healthcare Provider Details

I. General information

NPI: 1710200183
Provider Name (Legal Business Name): JANICE ELIZABETH WILLIAMS L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2010
Last Update Date: 05/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 5TH AVE
NEW YORK NY
10029-3119
US

IV. Provider business mailing address

244 5TH AVE STE W218
NEW YORK NY
10001-7604
US

V. Phone/Fax

Practice location:
  • Phone: 212-426-3400
  • Fax:
Mailing address:
  • Phone: 212-665-6544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number085539
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: