Healthcare Provider Details

I. General information

NPI: 1033918750
Provider Name (Legal Business Name): WILLIAMS CONSULTING & COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

452A JONES RANCH RD
VANDERWAGEN NM
87326-8039
US

IV. Provider business mailing address

PO BOX 4391
GALLUP NM
87305-4391
US

V. Phone/Fax

Practice location:
  • Phone: 623-499-5982
  • Fax:
Mailing address:
  • Phone: 623-499-5982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: LEVINA WILLIAMS
Title or Position: OWNER
Credential:
Phone: 623-499-5982