Healthcare Provider Details

I. General information

NPI: 1679673800
Provider Name (Legal Business Name): KAREN JANEEN WILLIAMS PSY D, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/25/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 CHERRYVILLE RD
SHELBY NC
28150-3651
US

IV. Provider business mailing address

253 FRANKLIN CT
STANLEY NC
28164-9609
US

V. Phone/Fax

Practice location:
  • Phone: 704-669-3678
  • Fax:
Mailing address:
  • Phone: 704-915-2777
  • Fax: 980-938-8533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5057
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: