Individual
MRS. MARY KATHERINE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
2233 N GREEN ACRES RD, FAYETTEVILLE, AR 72703-2833
(479) 466-9121
(479) 974-2002
Mailing address
4669 W TUMBLEWEED ST, FAYETTEVILLE, AR 72704-7642
(479) 466-9121
(479) 974-2002
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1752C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089.0134618TELE
SOCIAL WORK LICENSE
VT
01
—
1752C
SOCIAL WORK LICENSE
AR
01
—
5X496
BLUE CROSS PROVIDER #
AR
01
—
61413647
SOCIAL WORK LICENSE
WA
Enumeration date
05/04/2006
Last updated
10/24/2023
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