Provider Demographics
NPI:1508297979
Name:WILLIAMS, JULIE ANDRIA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANDRIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1711
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75106-1711
Mailing Address - Country:US
Mailing Address - Phone:469-672-5472
Mailing Address - Fax:817-405-7226
Practice Address - Street 1:7319 COMPAS
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-5511
Practice Address - Country:US
Practice Address - Phone:682-554-0663
Practice Address - Fax:817-477-9966
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66362101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32820204Medicaid