Provider Demographics
NPI:1427834696
Name:WILLIAMS, THIRSLON (LMHC)
Entity type:Individual
Prefix:
First Name:THIRSLON
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8141 BELLARUS WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1789
Mailing Address - Country:US
Mailing Address - Phone:727-910-2395
Mailing Address - Fax:866-698-8309
Practice Address - Street 1:8141 BELLARUS WAY STE 103
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1789
Practice Address - Country:US
Practice Address - Phone:727-910-2395
Practice Address - Fax:866-698-8309
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22633101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty