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General NPI Number Information
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NPI Number | 1366835316
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Entity Type | Individual
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Provider Name | CRYSTAL WILLIAMS MSW, LSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/16/2015
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Last Update Date | 08/11/2019
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Provider Practice Location Address
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Address Line | 4309 S KING DR
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City | CHICAGO
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State | IL
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Zip | 60653-3308
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Country | US
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Telephone | 773-451-1329
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Fax |
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Provider Business Mailing Address
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Address Line | 320 W 37TH ST FL 7
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City | NEW YORK
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State | NY
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Zip | 10018-4289
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.014112
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 149.019202
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License Number State | IL
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