Provider Demographics
NPI:1144238536
Name:WILLIAMS, CARROLL ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:CARROLL
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 FLYNN PKWY STE 412F
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4367
Mailing Address - Country:US
Mailing Address - Phone:361-960-4273
Mailing Address - Fax:361-452-8359
Practice Address - Street 1:5151 FLYNN PKWY STE 412F
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4367
Practice Address - Country:US
Practice Address - Phone:361-960-4273
Practice Address - Fax:361-452-8359
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17160101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145050402Medicaid