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NPI Code Detail

MEDICARE: MS. LISA A WILLIAMS LCPC, LAC

MEDICARE: MS. LISA A WILLIAMS LCPC, LAC
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 Counselor1130MT
2101YA0400XAddiction (Substance Use Disorder) Counselor3283MT

General Provider Information

NPI Number : 1275790289
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA A WILLIAMS LCPC, LAC
Provider Business Mailing Address
First Line : 2508 WILSON ST
Second Line :
City : MILES CITY
State : MT
Zip : 59301-5000
Country : US
Telephone Number : 406-234-1687
Fax Number :
Provider Business Practice Location Address
First Line : 2508 WILSON ST
Second Line :
City : MILES CITY
State : MT
Zip : 59301-5000
Country : US
Telephone Number : 406-234-1687
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2008
Last Update Date : 07/07/2015

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