Healthcare Provider Details

I. General information

NPI: 1568694206
Provider Name (Legal Business Name): LEAH DEDEAUX WILLIAMSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2009
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 KEY DR
MADISON MS
39110-5011
US

IV. Provider business mailing address

112 WINCHESTER LN
BRANDON MS
39042-3239
US

V. Phone/Fax

Practice location:
  • Phone: 601-898-4947
  • Fax:
Mailing address:
  • Phone: 601-467-9689
  • Fax: 601-429-9154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1403
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1403
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: