Provider Demographics
NPI:1962540963
Name:WILLIAMS, SAMUEL K (LCSW-LCAS)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:K
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LCSW-LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 GEORGIA AVE. NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20307-5001
Mailing Address - Country:US
Mailing Address - Phone:202-782-8009
Mailing Address - Fax:202-782-7589
Practice Address - Street 1:6900 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0003
Practice Address - Country:US
Practice Address - Phone:202-782-8009
Practice Address - Fax:202-782-7589
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0051651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical