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General NPI Number Information
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NPI Number | 1568181527
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Entity Type | Organization
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Legal Business Name | L. WILLIAMS THERAPY, LLC
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 2663 FARRAGUT DR
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City | SPRINGFIELD
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State | IL
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Zip | 62704-1462
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Country | US
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Telephone | 217-621-9849
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 S WALNUT ST
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City | SPRINGFIELD
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State | IL
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Zip | 62704-2852
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Country | US
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Telephone | 636-544-4802
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | LYN ALEXANDER WILLIAMS
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Credential | LCSW
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Telephone | 217-621-9849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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