MEDICARE: JESSICA MERRITT WILLIAMS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	8936	LA

General Provider Information

NPI Number	:	1578246120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA MERRITT WILLIAMS LPC

Provider Business Mailing Address
First Line	:	6059 CHERRY HILL AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71107-9131
Country	:	US
Telephone Number	:	318-205-0526
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 CHINABERRY DR STE 502
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-2462
Country	:	US
Telephone Number	:	318-519-1915
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2023
Last Update Date	:	01/21/2026

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