Provider Demographics
NPI:1366547168
Name:MCWILLIAMS, TINA ANN (LICSW)
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:ANN
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 CARTER DR
Mailing Address - Street 2:
Mailing Address - City:TUSCUMBIA
Mailing Address - State:AL
Mailing Address - Zip Code:35674-6917
Mailing Address - Country:US
Mailing Address - Phone:662-224-6210
Mailing Address - Fax:
Practice Address - Street 1:200 COUNTY ROAD 3941
Practice Address - Street 2:
Practice Address - City:ARLEY
Practice Address - State:AL
Practice Address - Zip Code:35541-2681
Practice Address - Country:US
Practice Address - Phone:166-222-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC57131041C0700X
TN44701041C0700X
AL1243C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1234COtherALABAMA BOARD OF SOCIAL WORK