Provider Demographics
NPI:1194541813
Name:WILLIAMS, TAMARA DENYSE
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:DENYSE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:DENYSE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:138 HIDDEN VALLEY CIR APT H
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-1702
Mailing Address - Country:US
Mailing Address - Phone:312-887-0100
Mailing Address - Fax:
Practice Address - Street 1:138 HIDDEN VALLEY CIR APT H
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-1702
Practice Address - Country:US
Practice Address - Phone:312-887-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-26
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85957101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health