Healthcare Provider Details

I. General information

NPI: 1366055014
Provider Name (Legal Business Name): AMANDA WILLIAMS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W CAPITOL AVE
LITTLE ROCK AR
72201-3436
US

IV. Provider business mailing address

301 BUNKER HILL AVE
WHITE HALL AR
71602-2506
US

V. Phone/Fax

Practice location:
  • Phone: 405-641-3923
  • Fax:
Mailing address:
  • Phone: 405-641-3923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP2308016
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP2308016
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: