Provider Demographics
NPI:1427860642
Name:WILLIAMS, RAENA JAMICE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:RAENA
Middle Name:JAMICE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:RAENA
Other - Middle Name:JAMICE
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1307 S IOWA ST APT C
Mailing Address - Street 2:
Mailing Address - City:PECOS
Mailing Address - State:TX
Mailing Address - Zip Code:79772-5627
Mailing Address - Country:US
Mailing Address - Phone:713-367-2592
Mailing Address - Fax:713-367-2592
Practice Address - Street 1:1307 S IOWA ST APT C
Practice Address - Street 2:
Practice Address - City:PECOS
Practice Address - State:TX
Practice Address - Zip Code:79772-5627
Practice Address - Country:US
Practice Address - Phone:713-367-2592
Practice Address - Fax:713-367-2592
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX694411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty