Provider Demographics
NPI:1235478439
Name:WILLIAMSON, LAKYTA (M ED, QMHP-C/A)
Entity Type:Individual
Prefix:
First Name:LAKYTA
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:M ED, QMHP-C/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 UNION ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-3434
Mailing Address - Country:US
Mailing Address - Phone:757-244-5178
Mailing Address - Fax:
Practice Address - Street 1:255 UNION ST UNIT B
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-3434
Practice Address - Country:US
Practice Address - Phone:757-244-5178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist