Provider Demographics
NPI:1134667439
Name:WILLIAMS, MAUREEN (LPC, LMAC)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC, LMAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 W 13TH ST N STE 9
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-2968
Mailing Address - Country:US
Mailing Address - Phone:316-640-0096
Mailing Address - Fax:
Practice Address - Street 1:7200 W 13TH ST N STE 9
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2968
Practice Address - Country:US
Practice Address - Phone:316-640-0096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3022101Y00000X
KS795101YA0400X
KS3119101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional