Healthcare Provider Details

I. General information

NPI: 1417633199
Provider Name (Legal Business Name): SARAH WILLIAMS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1461 ROAD 22
ATHOL ID
83801-9617
US

IV. Provider business mailing address

1461 ROAD 22
ATHOL ID
83801-9617
US

V. Phone/Fax

Practice location:
  • Phone: 208-691-1098
  • Fax: 866-485-9242
Mailing address:
  • Phone: 208-691-1098
  • Fax: 866-485-9242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-10028
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: