Tykera Ja'Risse Williams, MSW, LSWAIC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC60970283 Issued in WA

Practice address

75067 Ravenwood Dr
Yulee, FL 32097-1607

Phone

(410) 463-9857

NPI assigned

Nov 3, 2023

Last updated

Nov 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1306619093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76020 WILLIAM BURGESS BLVD UNIT 5-1098",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320975489",
            "telephone_number": "410-463-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75067 RAVENWOOD DR",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320971607",
            "telephone_number": "410-463-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TYKERA",
        "middle_name": "JA'RISSE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LSWAIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61502287",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60970283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Lynn Wilford
• Latonya Williams
• Macy Lynn Williams
• Miangel Williams
• Taylor Jordan Williams, M.S. SLP
• Alexis Wilson
• Jolynn Wilson, CSFA
• Sheena Wilson
• Marcia Winter, LCSW
• Women's Care Florida LLC

• Clinical Social Worker in Yulee, FL
• Providers in Yulee, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.