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General NPI Number Information
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NPI Number | 1922694579
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Entity Type | Individual
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Provider Name | ALISA WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 12/17/2020
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 17210 133RD AVE APT 13F
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City | JAMAICA
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State | NY
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Zip | 11434-3921
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Country | US
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Telephone | 516-787-4222
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Fax |
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Provider Business Mailing Address
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Address Line | 1144 13TH ST # 102233
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City | IMPERIAL BEACH
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State | CA
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Zip | 91932-3675
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Country | US
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Telephone | 718-915-7545
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 120165
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License Number State | CA
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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 | 090574
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License Number State | NY
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