Provider Demographics
NPI:1730692963
Name:WILLIAMS, CAROL LEE (MED, MHP, THERAPIST)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:LEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MED, MHP, THERAPIST
Other - Prefix:MISS
Other - First Name:CAROL
Other - Middle Name:LEE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CAROL WILLIAMS, MED
Mailing Address - Street 1:3722 S HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1920
Mailing Address - Country:US
Mailing Address - Phone:206-721-5542
Mailing Address - Fax:206-721-5917
Practice Address - Street 1:3722 S HUDSON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1920
Practice Address - Country:US
Practice Address - Phone:206-721-5542
Practice Address - Fax:206-721-5917
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60256265101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor