Provider Demographics
NPI:1740624311
Name:WILLIAMS, QUINCI (DMIN, CPSS, FSP)
Entity type:Individual
Prefix:MS
First Name:QUINCI
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DMIN, CPSS, FSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 W RIVERSIDE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-4658
Mailing Address - Country:US
Mailing Address - Phone:417-861-3965
Mailing Address - Fax:
Practice Address - Street 1:743 W RIVERSIDE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-4658
Practice Address - Country:US
Practice Address - Phone:417-861-3965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO22683101YM0800X
174H00000X, 101YA0400X, 251V00000X, 261QM0855X, 251S00000X, 1041C0700X, 3747P1801X, 101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174H00000XOther Service ProvidersHealth Educator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No251V00000XAgenciesVoluntary or Charitable
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000000000Medicaid