Provider Demographics
NPI:1366260903
Name:WILLIAMS, MYAH GRACE (LMSW)
Entity type:Individual
Prefix:
First Name:MYAH
Middle Name:GRACE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 ROUND ROCK WEST DR # E201
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5052
Mailing Address - Country:US
Mailing Address - Phone:512-730-9383
Mailing Address - Fax:
Practice Address - Street 1:507 DENALI PASS STE 601
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7980
Practice Address - Country:US
Practice Address - Phone:512-730-9383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62709104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker