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NPI Code Detail

MEDICARE: VENESSA RENEE WILLIAMS LPC

MEDICARE:   VENESSA RENEE 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
1171M00000XCase Manager/Care Coordinator
2101YP2500XProfessional CounselorPC013965PA

General Provider Information

NPI Number : 1730579624
Entity Type Code : Individual
Provider Name (Legal Business Name) : VENESSA RENEE WILLIAMS LPC
Provider Business Mailing Address
First Line : 7 DOCK HILL RD
Second Line :
City : MIDDLEBURG
State : PA
Zip : 17842-8910
Country : US
Telephone Number : 570-837-2123
Fax Number : 570-837-2185
Provider Business Practice Location Address
First Line : 270 SUSQUEHANNA VALLEY MALL DR STE 100
Second Line :
City : SELINSGROVE
State : PA
Zip : 17870-9115
Country : US
Telephone Number : 570-768-4441
Fax Number : 570-768-4195
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2015
Last Update Date : 12/02/2021

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Directions to “ VENESSA RENEE WILLIAMS LPC” Practice Location

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