Provider Demographics
NPI:1225572647
Name:WILLIAMS, HEATHER (PRSS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 N ROCHEBLAVE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-1425
Mailing Address - Country:US
Mailing Address - Phone:504-470-6127
Mailing Address - Fax:
Practice Address - Street 1:3114 FRENCHMEN ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-3609
Practice Address - Country:US
Practice Address - Phone:504-470-6127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11535175T00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist