Penne Williams, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW2237 Issued in FL

Practice address

3655 Innovation Dr
Lakeland, FL 33812-4106

Phone

(638) 225-7601

Fax

(866) 619-5995

NPI assigned

May 4, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1619550076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXPLORATION AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338123319",
            "telephone_number": "888-414-1413",
            "fax_number": "863-619-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 INNOVATION DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338124106",
            "telephone_number": "638-225-7601",
            "fax_number": "866-619-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PENNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW2237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "SW2237",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwilliams@reliancemedicalcenters.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "3655 Innovation Dr",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338124106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lamisha Williams
• Madison Paige Williams, PA-C
• Melissa Williams, MA, LMHC
• Michael Williams, DDS
• Nicole Rachelle Williams, COTA/L
• Randall Williams
• Rodney Dean Williams, PH.D.
• Samantha Williams, LPN
• Sara Williams
• Shantee Williams

• Clinical Social Worker in Lakeland, FL
• Providers in Lakeland, 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 May 4, 2021; 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.