Provider Demographics
NPI:1386848588
Name:WILLIAMS, SHAY ERIC (MED, LPC)
Entity Type:Individual
Prefix:MR
First Name:SHAY
Middle Name:ERIC
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 PARK LN W
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-5064
Mailing Address - Country:US
Mailing Address - Phone:956-202-1502
Mailing Address - Fax:
Practice Address - Street 1:202 PARK LN W
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-5064
Practice Address - Country:US
Practice Address - Phone:956-202-1502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61413101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional