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General NPI Number Information
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NPI Number | 1316495757
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Entity Type | Organization
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Legal Business Name | NICOLE WILLIAMS COUNSELING
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 3906 NORTH LAMAR BLVD SUITE 204 D
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City | AUSTIN
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State | TX
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Zip | 78756
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Country | US
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Telephone | 512-803-7212
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Fax |
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Provider Business Mailing Address
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Address Line | 3906 NORTH LAMAR BLVD SUITE 204 D
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City | AUSTIN
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State | TX
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Zip | 78756
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Country | US
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Telephone | 512-803-7212
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Fax |
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Authorized Official
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Title or Position | COUNSELOR/SOLE PROPRIETER
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Name | MS. NICOLE TANYA WILLIAMS
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Credential | LPC
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Telephone | 512-803-7212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 70582
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 70582
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License Number State | TX
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