Healthcare Provider Details

I. General information

NPI: 1437371242
Provider Name (Legal Business Name): LINDA SUE WILLIAMS MA LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDA SUE WILLIAMS MA LLP

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 01/04/2023
Certification Date: 01/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 LEONIDAS ST
NEW ORLEANS LA
70118-2156
US

IV. Provider business mailing address

1720 LEONIDAS ST
NEW ORLEANS LA
70118-2156
US

V. Phone/Fax

Practice location:
  • Phone: 269-873-2939
  • Fax: 269-000-0000
Mailing address:
  • Phone: 269-873-2939
  • Fax: 269-000-0000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6301010728
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: