Provider Demographics
NPI:1336228352
Name:WILLIAMS, CRAIG E (LPC,MC)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LPC,MC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1392
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74821-1392
Mailing Address - Country:US
Mailing Address - Phone:580-332-6317
Mailing Address - Fax:580-332-6384
Practice Address - Street 1:730 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-5614
Practice Address - Country:US
Practice Address - Phone:580-332-6317
Practice Address - Fax:580-332-6384
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2881101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2881OtherLPC