Provider Demographics
NPI:1225512205
Name:WILLIAMS, CHRISTA FUERST (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:FUERST
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 1:200 PARK CIRCLE DR STE 2
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-7800
Mailing Address - Country:US
Mailing Address - Phone:601-933-1136
Mailing Address - Fax:
Practice Address - Street 1:200 PARK CIRCLE DR
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7628
Practice Address - Country:US
Practice Address - Phone:601-933-1136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health