Provider Demographics
NPI:1043558315
Name:WILLIAMS, JOAN DENISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:DENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2167 KINGSBURY DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3429
Mailing Address - Country:US
Mailing Address - Phone:334-239-8597
Mailing Address - Fax:
Practice Address - Street 1:2167 KINGSBURY DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3429
Practice Address - Country:US
Practice Address - Phone:334-239-8597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3105101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL3105OtherLICENSED PROFESSIONAL COUNSELOR