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NPI Code Detail

MEDICARE: MS. AMY DENISE WILLIAMS LPC

MEDICARE: MS. AMY DENISE WILLIAMS LPC
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
1101YM0800XMental Health CounselorLPC011500GA

General Provider Information

NPI Number : 1255950879
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMY DENISE WILLIAMS LPC
Provider Business Mailing Address
First Line : 115 HABERSHAM DR
Second Line :
City : FAYETTEVILLE
State : GA
Zip : 30214-7353
Country : US
Telephone Number : 770-461-9944
Fax Number : 770-461-9779
Provider Business Practice Location Address
First Line : 115 HABERSHAM DR
Second Line :
City : FAYETTEVILLE
State : GA
Zip : 30214-7353
Country : US
Telephone Number : 770-461-9944
Fax Number : 770-461-9779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2020
Last Update Date : 04/14/2020

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