Healthcare Provider Details

I. General information

NPI: 1679665079
Provider Name (Legal Business Name): WILLIAMS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 ANNIE COURT
NORMAN OK
73069-4236
US

IV. Provider business mailing address

824 ANNIE COURT
NORMAN OK
73069-4236
US

V. Phone/Fax

Practice location:
  • Phone: 405-812-5934
  • Fax: 405-364-2697
Mailing address:
  • Phone: 405-812-5934
  • Fax: 405-364-2697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number2681
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2681
License Number StateOK

VIII. Authorized Official

Name: MRS. MYRNA JEAN WILLIAMS
Title or Position: OWNER CEO
Credential: LPC NCC
Phone: 405-812-5934