Provider Demographics
NPI:1235437484
Name:WILLIAMS, ANDREA DAWN (LPCC, CADC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:DAWN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPCC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 CHAMBERLAIN LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1159
Mailing Address - Country:US
Mailing Address - Phone:502-384-2844
Mailing Address - Fax:
Practice Address - Street 1:4601 CHAMBERLAIN LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-1159
Practice Address - Country:US
Practice Address - Phone:502-384-2844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0717101YA0400X
KYKY-0615101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional