Provider Demographics
NPI:1376909911
Name:WILLIAMS, ANNE MARIE (LPC, LISAC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 E CHOLLA ST # 102
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-2304
Mailing Address - Country:US
Mailing Address - Phone:623-850-4820
Mailing Address - Fax:
Practice Address - Street 1:4720 E CHOLLA ST # 102
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-2304
Practice Address - Country:US
Practice Address - Phone:623-850-4820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-10391101YA0400X
AZLPC-11752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)