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General NPI Number Information
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NPI Number | 1306485214
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Entity Type | Individual
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Provider Name | TONYA WILLIAMS BASW,CDCA,CPRS, LSW
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Gender | Female
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Dates
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Enumeration Date | 12/26/2019
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 2475 E 22ND ST FL 4
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City | CLEVELAND
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State | OH
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Zip | 44115-3209
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Country | US
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Telephone | 216-363-2570
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932004
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City | CLEVELAND
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State | OH
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Zip | 44193-0007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | LCDCIII.162423
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCDCIII.162423
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | LCDCIII.162423
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2005708
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License Number State | OH
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