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General NPI Number Information
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NPI Number | 1750142600
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Entity Type | Individual
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Provider Name | BREANA LYN WILLIAMS LPC
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Gender | Female
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 119 EXECUTIVE WAY STE 305
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City | DESOTO
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State | TX
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Zip | 75115-2341
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Country | US
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Telephone | 469-454-0389
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Fax |
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Provider Business Mailing Address
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Address Line | 2840 DUSTY RD
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City | FORNEY
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State | TX
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Zip | 75126-1600
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Country | US
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Telephone | 214-477-4551
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 93323
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 93323
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License Number State | TX
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