Provider Demographics
NPI:1134459134
Name:WILLIAMS, NICOLE ANDREA (LPC, CSAC, MAC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:ANDREA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC, CSAC, MAC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:WILLIAMS
Other - Last Name:AKINDOYO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, CSAC, MAC
Mailing Address - Street 1:7633 HULL STREET RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-6481
Mailing Address - Country:US
Mailing Address - Phone:804-955-9259
Mailing Address - Fax:804-528-5752
Practice Address - Street 1:7633 HULL STREET RD
Practice Address - Street 2:SUITE 300
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-6481
Practice Address - Country:US
Practice Address - Phone:804-955-9259
Practice Address - Fax:804-528-5752
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007037101Y00000X, 101YP2500X, 101YM0800X
VA0710102614101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional