Healthcare Provider Details

I. General information

NPI: 1114471554
Provider Name (Legal Business Name): STEPHANIE WILLIAMSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2016
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 PHILO RD
URBANA IL
61802-8007
US

IV. Provider business mailing address

2001 PHILO RD
URBANA IL
61802-8007
US

V. Phone/Fax

Practice location:
  • Phone: 217-638-1195
  • Fax:
Mailing address:
  • Phone: 217-638-1195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178019249
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: