Provider Demographics
NPI:1215291752
Name:WILLIAMS, NANCY LEE (MA, LMHT, BCPPC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:LEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, LMHT, BCPPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 SUTTON CIRCLE DR N
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-1142
Mailing Address - Country:US
Mailing Address - Phone:260-824-0090
Mailing Address - Fax:260-824-1374
Practice Address - Street 1:1515 SUTTON CIRCLE DR N
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-1142
Practice Address - Country:US
Practice Address - Phone:260-824-0090
Practice Address - Fax:260-824-1374
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000527A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health