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General NPI Number Information
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NPI Number | 1427137801
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Entity Type | Individual
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Provider Name | VALLERIA DEANNA FORNEY-WILLIAMS LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/04/2006
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 389 VININGS VINTAGE CIR STE 201
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City | MABLETON
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State | GA
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Zip | 30126-7237
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Country | US
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Telephone | 630-400-8359
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Fax | 9-638-2028
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Provider Business Mailing Address
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Address Line | 389 VININGS VINTAGE CIR
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City | MABLETON
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State | GA
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Zip | 30126-7237
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Country | US
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Telephone | 630-400-8359
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Fax | 800-963-8202
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.012051
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW004370
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License Number State | GA
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