Healthcare Provider Details

I. General information

NPI: 1386310092
Provider Name (Legal Business Name): TERRYN WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2021
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 CONCORD RD SE
SMYRNA GA
30080-4361
US

IV. Provider business mailing address

2908 COTTESFORD WAY SE
SMYRNA GA
30080-2192
US

V. Phone/Fax

Practice location:
  • Phone: 678-990-1880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: