Provider Demographics
NPI:1194024679
Name:WILLIAMS, TONI SHAWNTA (P-LCSW)
Entity type:Individual
Prefix:MISS
First Name:TONI
Middle Name:SHAWNTA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 OBSIDIAN WAY
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6672
Mailing Address - Country:US
Mailing Address - Phone:919-452-6383
Mailing Address - Fax:
Practice Address - Street 1:708 OBSIDIAN WAY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-6672
Practice Address - Country:US
Practice Address - Phone:919-452-6383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0059711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical