Healthcare Provider Details

I. General information

NPI: 1477222982
Provider Name (Legal Business Name): SHAMREE LYNN WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W 40TH ST STE 358
BALTIMORE MD
21211-2111
US

IV. Provider business mailing address

2930 ALEXANDER AVE
TEXARKANA TX
75501-7374
US

V. Phone/Fax

Practice location:
  • Phone: 903-559-6416
  • Fax:
Mailing address:
  • Phone: 903-559-6416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC15417
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: