Provider Demographics
NPI:1154198190
Name:WILLIAMSON-KERSEY, LINDA SUZANNE (LMSW, CSW, CADC LL,)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUZANNE
Last Name:WILLIAMSON-KERSEY
Suffix:
Gender:F
Credentials:LMSW, CSW, CADC LL,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 OAKLAND WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-0917
Mailing Address - Country:US
Mailing Address - Phone:917-579-4643
Mailing Address - Fax:
Practice Address - Street 1:76 OAKLAND WAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-0917
Practice Address - Country:US
Practice Address - Phone:914-403-9198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY258470104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker