MEDICARE: MR. ANTHONY JAMES WILLIAMS LPC, LMFT

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	106H00000X	Marriage & Family Therapist	61	LA
2	101YM0800X	Mental Health Counselor	1692	LA

General Provider Information

NPI Number	:	1952458598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY JAMES WILLIAMS LPC, LMFT

Provider Business Mailing Address
First Line	:	4300 YOUREE DR
Second Line	:	SUITE 320-A
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-3329
Country	:	US
Telephone Number	:	318-219-9508
Fax Number	:	318-219-9514

Provider Business Practice Location Address
First Line	:	7505 PINES RD STE 1292
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71129-3900
Country	:	US
Telephone Number	:	318-219-9508
Fax Number	:	318-219-9514

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

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	12/21/2019

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