Healthcare Provider Details

I. General information

NPI: 1023924552
Provider Name (Legal Business Name): AMYA R WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 OLD ROUTE 119 HIGHWAY NORTH
INDIANA PA
15701
US

IV. Provider business mailing address

793 OLD ROUTE 119 HIGHWAY NORTH
INDIANA PA
15701
US

V. Phone/Fax

Practice location:
  • Phone: 724-465-5576
  • Fax:
Mailing address:
  • Phone: 724-465-5576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: