Provider Demographics
NPI:1104485960
Name:WILLIAMS, HANNA KELSEY (LMSW)
Entity type:Individual
Prefix:MRS
First Name:HANNA
Middle Name:KELSEY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 GLENN ST SE STE 2
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IA
Mailing Address - Zip Code:52314-1501
Mailing Address - Country:US
Mailing Address - Phone:319-777-1092
Mailing Address - Fax:319-449-3585
Practice Address - Street 1:204 GLENN ST SE STE 2
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IA
Practice Address - Zip Code:52314-1501
Practice Address - Country:US
Practice Address - Phone:319-777-1092
Practice Address - Fax:319-449-3585
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0955061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical