MEDICARE: MS. GLORIA WILLIAMS LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	056373	NY

General Provider Information

NPI Number	:	1285772145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GLORIA WILLIAMS LMSW

Provider Business Mailing Address
First Line	:	224 HIGHLAND BLVD
Second Line	:	APARTMENT NO. 611
City	:	BROOKLYN
State	:	NY
Zip	:	11207-1949
Country	:	US
Telephone Number	:	347-551-1492
Fax Number	:

Provider Business Practice Location Address
First Line	:	2581 ATLANTIC AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11207-2412
Country	:	US
Telephone Number	:	718-495-6700
Fax Number	:	718-485-4018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/08/2007

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