Provider Demographics
NPI:1346779766
Name:WILLIAMS, SHELSY DIANE
Entity Type:Individual
Prefix:
First Name:SHELSY
Middle Name:DIANE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 HAZEL ST
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-2107
Mailing Address - Country:US
Mailing Address - Phone:337-466-8695
Mailing Address - Fax:
Practice Address - Street 1:1520 HAZEL STREET
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535
Practice Address - Country:US
Practice Address - Phone:337-466-8695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator