Provider Demographics
NPI:1659263226
Name:WILLIAMS, GWENDOLYN J (LPC)
Entity type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 FLEETFOOT DR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-6306
Mailing Address - Country:US
Mailing Address - Phone:414-254-1717
Mailing Address - Fax:
Practice Address - Street 1:921 FLEETFOOT DR
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-6306
Practice Address - Country:US
Practice Address - Phone:414-254-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11291-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional