Provider Demographics
NPI:1235259896
Name:WILLIAMS, MICHAEL HOWARD (LPC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HOWARD
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2478 13TH ST SE
Mailing Address - Street 2:200
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-2546
Mailing Address - Country:US
Mailing Address - Phone:503-561-5582
Mailing Address - Fax:503-561-2707
Practice Address - Street 1:2478 13TH ST SE
Practice Address - Street 2:200
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-2546
Practice Address - Country:US
Practice Address - Phone:503-561-5582
Practice Address - Fax:503-561-2707
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLPC 1599101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional