Provider Demographics
NPI:1376976209
Name:WILLIAMS, EDDIE JAMES JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:EDDIE
Middle Name:JAMES
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:132 WINNSTEAD DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-5368
Mailing Address - Country:US
Mailing Address - Phone:229-435-4135
Mailing Address - Fax:229-435-4135
Practice Address - Street 1:132 WINNSTEAD DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-5368
Practice Address - Country:US
Practice Address - Phone:229-435-4135
Practice Address - Fax:229-435-4135
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005331101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional