Provider Demographics
NPI:1154608024
Name:WILLIAMS, PAMELA A (LCSW-C)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 S MADEIRA ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-2025
Mailing Address - Country:US
Mailing Address - Phone:410-279-8114
Mailing Address - Fax:
Practice Address - Street 1:118 S MADEIRA ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-2025
Practice Address - Country:US
Practice Address - Phone:410-279-8114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW003527E104100000X
MD168231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker