Cecil Williams Jr., LCSW
Individual provider Active NPI Clinical Social Worker · Banner, KY
NPI 1346002102 · NPPES record last updated Jan 26, 2024
Key facts
- NPI
- 1346002102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 258682 (KY)
- Practice address
- 122 Holbrook Dr
Banner, KY 41603-8962 - Phone
- (606) 218-5717
- NPI assigned
- Jan 26, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 258682 | KY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 258682 | KY | Yes |
Addresses
Primary practice location
122 Holbrook Dr
Banner, KY 41603-8962
Mailing address
122 Holbrook Dr
Banner, KY 41603-8962
Phone (606) 218-5717
Other practice location 1
147 Sycamore St
Pikeville, KY 41501-9118
Phone (606) 434-9195
Other providers in Banner, KY
All providers in Banner, KY · Clinical Social Worker in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.