Provider Demographics
NPI:1497479190
Name:WILLIAMSON, MACY (LPC)
Entity Type:Individual
Prefix:
First Name:MACY
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MACY
Other - Middle Name:
Other - Last Name:WALTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3008 PIN OAK LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-2815
Mailing Address - Country:US
Mailing Address - Phone:318-243-2979
Mailing Address - Fax:
Practice Address - Street 1:8913 MID CITIES BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-4912
Practice Address - Country:US
Practice Address - Phone:817-554-1960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty