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General NPI Number Information
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NPI Number | 1497998249
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Entity Type | Organization
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Legal Business Name | MARTHA WILLIAMS, LCSW
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Dates
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Enumeration Date | 04/09/2009
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Last Update Date | 04/09/2009
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Provider Practice Location Address
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Address Line | 8301 HIGHWAY 87 W
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City | HENNING
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State | TN
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Zip | 38041-6234
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Country | US
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Telephone | 731-413-2422
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Fax | 731-738-0300
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Provider Business Mailing Address
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Address Line | 4789 HIGHWAY 371
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City | HENNING
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State | TN
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Zip | 38041-6319
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Country | US
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Telephone | 731-413-2422
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Fax | 731-738-0300
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARTHA WILLIAMS
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Credential | LCSW
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Telephone | 731-413-2422
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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 | LSW000001215
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License Number State | TN
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