Provider Demographics
NPI:1043784358
Name:WILLIAMS, YOLANDA ANN (LCDC)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 JEFF SCOTT DR APT C
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4587
Mailing Address - Country:US
Mailing Address - Phone:254-466-2531
Mailing Address - Fax:
Practice Address - Street 1:4402 JEFF SCOTT DR APT C
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4587
Practice Address - Country:US
Practice Address - Phone:254-466-2531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-20
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15141101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)