Provider Demographics
NPI:1306244017
Name:WILLIAMS, CHRISTIE S (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:S
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:PO BOX 576
Mailing Address - Street 2:
Mailing Address - City:DOVE CREEK
Mailing Address - State:CO
Mailing Address - Zip Code:81324-0576
Mailing Address - Country:US
Mailing Address - Phone:970-677-3642
Mailing Address - Fax:970-677-2540
Practice Address - Street 1:43290 ROAD J.9 LOOP
Practice Address - Street 2:
Practice Address - City:MANCOS
Practice Address - State:CO
Practice Address - Zip Code:81328-7903
Practice Address - Country:US
Practice Address - Phone:970-799-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW099230891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical