Provider Demographics
NPI:1407947997
Name:WILLIAMSON, JOAN M (LPC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 WILDWIND DR SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-3146
Mailing Address - Country:US
Mailing Address - Phone:503-364-9530
Mailing Address - Fax:
Practice Address - Street 1:965 LIBERTY ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4138
Practice Address - Country:US
Practice Address - Phone:503-588-2004
Practice Address - Fax:503-588-2415
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0982101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health