Healthcare Provider Details

I. General information

NPI: 1427119908
Provider Name (Legal Business Name): YVONNE WILLIAMS LPCC, RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 RIVERSIDE PLAZA LN NW STE 260
ALBUQUERQUE NM
87120-2160
US

IV. Provider business mailing address

10625 PASTIME AVE NW
ALBUQUERQUE NM
87114-5004
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-3829
  • Fax:
Mailing address:
  • Phone: 505-350-8452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0112781
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: