Provider Demographics
NPI:1083676811
Name:WILLIAMS, JUDITH ELLEN (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ELLEN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 SOUTH TRIMBLE RD
Mailing Address - Street 2:STE D
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906
Mailing Address - Country:US
Mailing Address - Phone:419-756-9975
Mailing Address - Fax:419-756-1405
Practice Address - Street 1:605 SOUTH TRIMBLE RD
Practice Address - Street 2:STE D
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906
Practice Address - Country:US
Practice Address - Phone:419-756-9975
Practice Address - Fax:419-756-1405
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0001966101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH347125562A20OtherMAGELLAN