Healthcare Provider Details

I. General information

NPI: 1578960449
Provider Name (Legal Business Name): JANET MARIE WILLIAMS LLP, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2014
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 E COLBY ST
WHITEHALL MI
49461-1104
US

IV. Provider business mailing address

1495 S WOLF LAKE RD
MUSKEGON MI
49442-4837
US

V. Phone/Fax

Practice location:
  • Phone: 231-893-8336
  • Fax:
Mailing address:
  • Phone: 231-903-7775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401010505
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301013669
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number1-04794
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: