MEDICARE: WILLIAMS CHRISTIAN COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1114808854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMS CHRISTIAN COUNSELING, LLC

Provider Business Mailing Address
First Line	:	1249 MAUL RD
Second Line	:
City	:	CAMDEN
State	:	AR
Zip	:	71701-2785
Country	:	US
Telephone Number	:	870-315-5988
Fax Number	:

Provider Business Practice Location Address
First Line	:	1249 MAUL RD
Second Line	:
City	:	CAMDEN
State	:	AR
Zip	:	71701-2785
Country	:	US
Telephone Number	:	870-315-5988
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	DIANE WILLIAMS
Credential	:	LPC
Telephone Number	:	870-315-5988

Provider Enumeration Date	:	09/09/2025
Last Update Date	:	09/09/2025

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