Provider Demographics
NPI:1447064944
Name:WILLIAMS, LA GRETTA (LCSW-A)
Entity type:Individual
Prefix:
First Name:LA GRETTA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 GLEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596-7409
Mailing Address - Country:US
Mailing Address - Phone:501-952-3096
Mailing Address - Fax:
Practice Address - Street 1:4312 WAKE FOREST RD STE 2D-5
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6160
Practice Address - Country:US
Practice Address - Phone:984-212-2660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0215241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical