MEDICARE: MRS. WHITNEY RENEE WILLIAMS LMHC

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	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor	MH24221	FL

General Provider Information

NPI Number	:	1770022378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. WHITNEY RENEE WILLIAMS LMHC

Provider Business Mailing Address
First Line	:	422 WHISPERING CREEK AVE
Second Line	:
City	:	FREEPORT
State	:	FL
Zip	:	32439-3129
Country	:	US
Telephone Number	:	352-615-0879
Fax Number	:

Provider Business Practice Location Address
First Line	:	4476 LEGENDARY DR STE 203
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32541-5347
Country	:	US
Telephone Number	:	352-615-0879
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2017
Last Update Date	:	10/23/2024

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