Healthcare Provider Details
I. General information
NPI: 1114544038
Provider Name (Legal Business Name): AIMEE D. WILLIAMS MHS, LPC, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/26/2020
Last Update Date: 05/03/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5835 CAMPBELLTON RD SW
ATLANTA GA
30331-8013
US
IV. Provider business mailing address
5835 CAMPBELLTON RD SW
ATLANTA GA
30331-8013
US
V. Phone/Fax
- Phone: 404-666-9261
- Fax:
- Phone: 404-666-9261
- Fax: 866-404-2691
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 004738 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: