Healthcare Provider Details

I. General information

NPI: 1699984542
Provider Name (Legal Business Name): JACQUELINE MICHELLE WILLIAMS READE MS, PHD, LMFT, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACQUELINE WILLIAMS M.S.

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 W HIGHLAND AVE
REDLANDS CA
92373-6680
US

IV. Provider business mailing address

1245 W HIGHLAND AVE
REDLANDS CA
92373-6680
US

V. Phone/Fax

Practice location:
  • Phone: 909-206-2001
  • Fax:
Mailing address:
  • Phone: 206-406-8683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number70359
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number87056
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number461
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: