1174061428 NPI number — MS. ANREA MONIQUE WILLIAMS LCSW, MED

Table of content: MS. ANREA MONIQUE WILLIAMS LCSW, MED (NPI 1174061428)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174061428 NPI number — MS. ANREA MONIQUE WILLIAMS LCSW, MED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
ANREA
Provider Middle Name:
MONIQUE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW, MED
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
THOMAS
Provider Other First Name:
ANREA
Provider Other Middle Name:
WILLIAMS
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174061428
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5500 PERKINS RD
Provider Second Line Business Mailing Address:
#1119
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70808-4169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-485-1481
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4348 S JEFFREY DR
Provider Second Line Business Practice Location Address:
SUIT 102
Provider Business Practice Location Address City Name:
BATON ROUGE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70816-4196
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-361-0219
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  614287 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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