Healthcare Provider Details

I. General information

NPI: 1649756693
Provider Name (Legal Business Name): MARVA C. WILLIAMS M.DIV, MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2680 OPITZ BLVD STE 220
WOODBRIDGE VA
22192-6821
US

IV. Provider business mailing address

8062 KINGSTON PIKE
KNOXVILLE TN
37919-5524
US

V. Phone/Fax

Practice location:
  • Phone: 703-828-8053
  • Fax:
Mailing address:
  • Phone: 540-699-0717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number070106078
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: