Provider Demographics
NPI:1104966100
Name:WILLIAMS, LA SHEMAH RACQUEL (LCSW)
Entity type:Individual
Prefix:MS
First Name:LA SHEMAH
Middle Name:RACQUEL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 LANGDON BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3516
Mailing Address - Country:US
Mailing Address - Phone:347-351-5344
Mailing Address - Fax:
Practice Address - Street 1:45 PLAZA ST W
Practice Address - Street 2:SUITE 1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3952
Practice Address - Country:US
Practice Address - Phone:347-351-5344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0772721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical