Individual
LAQUNANA WILLIAMS CISTRUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LISW
Contact information
Practice address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
Mailing address
1027 MADISON ST, JACKSON, MS 39202-2725
(812) 538-9088
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
12671-C
NV
1041C0700X
Clinical Social Worker
133686
IA
1041C0700X
Clinical Social Worker
Primary
C-11480
MS
1041C0700X
Clinical Social Worker
CSW04031
RI
Other
Enumeration date
12/21/2023
Last updated
10/06/2025
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