Provider Demographics
NPI:1891058285
Name:WILLIAMS, JUDY (CAROLYN) (LPC)
Entity type:Individual
Prefix:
First Name:JUDY (CAROLYN)
Middle Name:
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 1:200 N RUFE SNOW DR STE 207
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-4239
Mailing Address - Country:US
Mailing Address - Phone:817-337-5292
Mailing Address - Fax:817-431-9060
Practice Address - Street 1:200 N RUFE SNOW DR STE 207
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-4239
Practice Address - Country:US
Practice Address - Phone:817-337-5292
Practice Address - Fax:817-431-9060
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14953101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional