MEDICARE: PAMELA WELLS WILLIAMS LPC/MHSP

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	101YM0800X	Mental Health Counselor	LPC0000001864	TN

General Provider Information

NPI Number	:	1922260918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA WELLS WILLIAMS LPC/MHSP

Provider Business Mailing Address
First Line	:	1324 TROTWOOD AVE
Second Line	:	SUITE 6
City	:	COLUMBIA
State	:	TN
Zip	:	38401-4750
Country	:	US
Telephone Number	:	931-388-9668
Fax Number	:	931-223-6047

Provider Business Practice Location Address
First Line	:	1324 TROTWOOD AVE
Second Line	:	SUITE 6
City	:	COLUMBIA
State	:	TN
Zip	:	38401-4750
Country	:	US
Telephone Number	:	931-388-9668
Fax Number	:	931-223-6047

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

Provider Enumeration Date	:	06/30/2008
Last Update Date	:	06/30/2008

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