Provider Demographics
NPI:1326094012
Name:WILLIAMS, HEATHER L (LPC)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:W
Other - Last Name:COWHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:6300 WOOLGRASS CT
Mailing Address - Street 2:
Mailing Address - City:STEDMAN
Mailing Address - State:NC
Mailing Address - Zip Code:28391-9098
Mailing Address - Country:US
Mailing Address - Phone:910-322-0024
Mailing Address - Fax:
Practice Address - Street 1:2018 FORT BRAGG RD
Practice Address - Street 2:SUITE 110-A
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-7037
Practice Address - Country:US
Practice Address - Phone:910-322-0024
Practice Address - Fax:910-483-3400
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4616101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3103201Medicaid