=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801151436
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOANNE E WILLIAMS LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2012
-----------------------------------------------------
Last Update Date | 09/01/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2701 S CARAWAY RD STE B1
-----------------------------------------------------
City | JONESBORO
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72401-7336
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-790-1766
-----------------------------------------------------
Fax | 870-292-3431
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2701 S CARAWAY RD STE B1
-----------------------------------------------------
City | JONESBORO
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72401-7336
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-790-1766
-----------------------------------------------------
Fax | 870-292-3431
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 6636-C
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------