Provider Demographics
NPI:1649868316
Name:WILLIAMS, PETA-GAYE SHEREE (LICSW, LCSW)
Entity type:Individual
Prefix:
First Name:PETA-GAYE
Middle Name:SHEREE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26246 WESLEY CHAPEL BLVD # 84
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-7206
Mailing Address - Country:US
Mailing Address - Phone:813-461-0058
Mailing Address - Fax:
Practice Address - Street 1:26246 WESLEY CHAPEL BLVD # 84
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-7206
Practice Address - Country:US
Practice Address - Phone:813-461-0058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500812871041C0700X
FLSW142571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty