Provider Demographics
NPI:1386960888
Name:WILLIAMS, JULIE T (MS, LPC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:T
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SAME
Mailing Address - Street 1:1830 LOGIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-3713
Mailing Address - Country:US
Mailing Address - Phone:980-406-3090
Mailing Address - Fax:
Practice Address - Street 1:1830 LOGIE AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-3713
Practice Address - Country:US
Practice Address - Phone:980-406-3090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7827101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104678Medicaid