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General NPI Number Information
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NPI Number | 1710232277
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Entity Type | Individual
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Provider Name | MONIQUE ANTOINETTE WILLIAMS LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/19/2012
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 410 STATE STREET
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City | NORTH HAVEN
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State | CT
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Zip | 06473-3147
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Country | US
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Telephone | 203-936-9213
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Fax |
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Provider Business Mailing Address
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Address Line | 2 SUMMER HILL RD.
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City | MIDDLETOWN
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State | CT
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Zip | 06457-5645
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Country | US
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Telephone | 617-817-2538
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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 |
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License Number State |
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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 | 011757
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License Number State | CT
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