Provider Demographics
NPI:1255496212
Name:WILLIAMS, DAVID O (LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:O
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3525 RUFFED GROUSE RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE MTN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-4447
Mailing Address - Country:US
Mailing Address - Phone:801-836-8678
Mailing Address - Fax:801-796-0475
Practice Address - Street 1:313 E 1200 S
Practice Address - Street 2:SUITE # 101
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6972
Practice Address - Country:US
Practice Address - Phone:801-836-8678
Practice Address - Fax:801-796-0475
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT346397-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional