Provider Demographics
NPI:1093585994
Name:WILLIAMS, LAQUITA SHAUNAE (LPC, CSOTP, SAC-S)
Entity Type:Individual
Prefix:
First Name:LAQUITA
Middle Name:SHAUNAE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC, CSOTP, SAC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 WESTERRE PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1339
Mailing Address - Country:US
Mailing Address - Phone:888-978-3801
Mailing Address - Fax:888-978-3802
Practice Address - Street 1:3900 WESTERRE PKWY
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-1478
Practice Address - Country:US
Practice Address - Phone:888-978-3801
Practice Address - Fax:888-978-3802
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health