Provider Demographics
NPI:1164029187
Name:WILLIAMS, AMI BALLAY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMI
Middle Name:BALLAY
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 1:209 ELSING GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23075-2455
Mailing Address - Country:US
Mailing Address - Phone:804-252-9391
Mailing Address - Fax:
Practice Address - Street 1:827 E PARHAM RD STE 4
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1126
Practice Address - Country:US
Practice Address - Phone:804-252-9391
Practice Address - Fax:804-215-3218
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009956101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional