Provider Demographics
NPI:1164010260
Name:WILLIAMSON, PHILIP ANDREW (LPC, QMHP A & C)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:ANDREW
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:LPC, QMHP A & C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 TURNING POINT DR
Mailing Address - Street 2:
Mailing Address - City:EVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24550-3775
Mailing Address - Country:US
Mailing Address - Phone:803-257-6400
Mailing Address - Fax:
Practice Address - Street 1:202 TURNING POINT DR
Practice Address - Street 2:
Practice Address - City:EVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24550-3775
Practice Address - Country:US
Practice Address - Phone:803-257-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLPC7713101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional