Provider Demographics
NPI:1063539468
Name:WILLIAMS, STANLEY EDWARD (LPC)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:EDWARD
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 VICKERY LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-2532
Mailing Address - Country:US
Mailing Address - Phone:912-884-4154
Mailing Address - Fax:
Practice Address - Street 1:406 BAY ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-1208
Practice Address - Country:US
Practice Address - Phone:912-443-0447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002127101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional