Provider Demographics
NPI:1962909143
Name:WILLIAMS, ELISABETH ANN (LCSW)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:ANN
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 1:44 SMYTHE DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMS BAY
Mailing Address - State:WI
Mailing Address - Zip Code:53191-9714
Mailing Address - Country:US
Mailing Address - Phone:262-729-2180
Mailing Address - Fax:
Practice Address - Street 1:44 SMYTHE DR
Practice Address - Street 2:
Practice Address - City:WILLIAMS BAY
Practice Address - State:WI
Practice Address - Zip Code:53191-9714
Practice Address - Country:US
Practice Address - Phone:262-729-2180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI129869-1211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical