Healthcare Provider Details

I. General information

NPI: 1679364764
Provider Name (Legal Business Name): DRENNAN LEE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1562 DAIRY RD
CHARLOTTESVILLE VA
22903-1304
US

IV. Provider business mailing address

1547 SHADY FOREST WAY
CHARLOTTESVILLE VA
22901-9047
US

V. Phone/Fax

Practice location:
  • Phone: 434-245-2400
  • Fax:
Mailing address:
  • Phone: 803-230-6935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number0813001297
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: