Healthcare Provider Details

I. General information

NPI: 1972191971
Provider Name (Legal Business Name): ANDREA JEAN WILLIAMS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 LEESTOWN RD
LEXINGTON KY
40511-1052
US

IV. Provider business mailing address

206 HUTCHINS DR
GEORGETOWN KY
40324-1083
US

V. Phone/Fax

Practice location:
  • Phone: 859-233-4511
  • Fax:
Mailing address:
  • Phone: 859-230-1644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number20043381A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: