Provider Demographics
NPI:1194587832
Name:WILLIAMS-GARRAWAY, TREENECIA ROCHELLE (P-LPC, NCC, NCSC)
Entity type:Individual
Prefix:
First Name:TREENECIA
Middle Name:ROCHELLE
Last Name:WILLIAMS-GARRAWAY
Suffix:
Gender:F
Credentials:P-LPC, NCC, NCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 CLAYTON PL
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-2706
Mailing Address - Country:US
Mailing Address - Phone:601-466-1015
Mailing Address - Fax:
Practice Address - Street 1:117 TOWNSEND ST
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-6469
Practice Address - Country:US
Practice Address - Phone:601-466-1015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP-0702101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health