Provider Demographics
NPI:1275790289
Name:WILLIAMS, LISA A (LCPC, LAC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-5000
Mailing Address - Country:US
Mailing Address - Phone:406-234-1687
Mailing Address - Fax:
Practice Address - Street 1:2508 WILSON ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5000
Practice Address - Country:US
Practice Address - Phone:406-234-1687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1130101YM0800X
MT3283101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health