Renardis E Williams, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC200001383 Issued in DC

Practice address

2611 Sierra Nevada Ave
Upper Marlboro, MD 20774-2687

Phone

(704) 968-1186

NPI assigned

Oct 12, 2022

Last updated

Feb 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1447976410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 SIERRA NEVADA AVE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207742687",
            "telephone_number": "704-968-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 SIERRA NEVADA AVE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207742687",
            "telephone_number": "704-968-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RENARDIS",
        "middle_name": "E",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-12",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200001383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720229958",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monique La Shon Williams, RPSGT
• Nicole A. Williams
• Omiome Williams
• Pamela Darlene Williams
• Ralph Jerome Williams Jr.
• Severina Williams
• Tiara Williams, LMSW
• Tiffany Williams, LPC
• Joni Lachelle Williamson-Turner, PSYD, IBCLC
• Willie Simmons

• Clinical Social Worker in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.