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NPI Code Detail

MEDICARE: KENYA WILLIAMSON LPC

MEDICARE: KENYA WILLIAMSON 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
1101YP2500XProfessional Counselor67726TX

General Provider Information

NPI Number : 1891357661
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENYA WILLIAMSON LPC
Provider Business Mailing Address
First Line : 5601 BRIDGE ST STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76112-2355
Country : US
Telephone Number : 682-214-0607
Fax Number : 682-232-0611
Provider Business Practice Location Address
First Line : 5601 BRIDGE ST STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76112-2355
Country : US
Telephone Number : 682-214-0607
Fax Number : 682-232-0611
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2019
Last Update Date : 07/02/2019

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Directions to “ KENYA WILLIAMSON LPC” Practice Location

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