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NPI Code Detail

MEDICARE: WILLIAMS WELLSPRING COUNSELING, PLLC

MEDICARE: WILLIAMS WELLSPRING COUNSELING, PLLC
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
1251S00000XCommunity/Behavioral Health Agency00318-LCNV
2251S00000XCommunity/Behavioral Health Agency00072-LCSNV
3251S00000XCommunity/Behavioral Health Agency292672NV
4251S00000XCommunity/Behavioral Health AgencyCP0176NV

General Provider Information

NPI Number : 1750750584
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILLIAMS WELLSPRING COUNSELING, PLLC
Provider Business Mailing Address
First Line : 1917 NAVARRE LN
Second Line :
City : HENDERSON
State : NV
Zip : 89014-5106
Country : US
Telephone Number : 702-355-4376
Fax Number :
Provider Business Practice Location Address
First Line : 3663 E SUNSET RD
Second Line : BLDG.#1, SUITE #104
City : LAS VEGAS
State : NV
Zip : 89120-3218
Country : US
Telephone Number : 702-355-4376
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ANITA WILLIAMS MS
Credential : LCPC,LCADC,LCS,NCC
Telephone Number : 702-355-4376
Provider Enumeration Date : 09/23/2015
Last Update Date : 05/02/2017

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