Provider Demographics
NPI:1417439183
Name:WILLIAMS, DANIELLE R (MA)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:DANI
Other - Middle Name:
Other - Last Name:YATES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49204-0047
Mailing Address - Country:US
Mailing Address - Phone:317-253-7387
Mailing Address - Fax:
Practice Address - Street 1:2437 SHELBY ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-4252
Practice Address - Country:US
Practice Address - Phone:317-253-7387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor