Provider Demographics
NPI:1477370773
Name:WILLIAMSON, JOSHUA (MA, NCC, LPC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:JOSH
Other - Middle Name:
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, NCC, LPC
Mailing Address - Street 1:515 AVONDALE DR
Mailing Address - Street 2:
Mailing Address - City:EAST PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61611-1645
Mailing Address - Country:US
Mailing Address - Phone:309-669-8318
Mailing Address - Fax:
Practice Address - Street 1:8801 N UNIVERSITY ST
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615-1635
Practice Address - Country:US
Practice Address - Phone:309-676-0538
Practice Address - Fax:309-214-0096
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.013343101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional