Provider Demographics
NPI:1720816762
Name:WILLIAMS, ROBBIE BURNETTE (LCSW)
Entity type:Individual
Prefix:
First Name:ROBBIE
Middle Name:BURNETTE
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 13006
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71273-3006
Mailing Address - Country:US
Mailing Address - Phone:318-617-8010
Mailing Address - Fax:
Practice Address - Street 1:413 S FARMERVILLE ST
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-4654
Practice Address - Country:US
Practice Address - Phone:318-548-1463
Practice Address - Fax:318-548-9202
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA43811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical