Provider Demographics
NPI:1518191774
Name:ATKINS, WILLIE JAMES (MA COUNSELING)
Entity Type:Individual
Prefix:
First Name:WILLIE
Middle Name:JAMES
Last Name:ATKINS
Suffix:
Gender:M
Credentials:MA COUNSELING
Other - Prefix:MR
Other - First Name:W.
Other - Middle Name:J
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3306 BALOMEDE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75216-2429
Mailing Address - Country:US
Mailing Address - Phone:972-228-4267
Mailing Address - Fax:972-228-4267
Practice Address - Street 1:2202 HARLANDALE AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-2429
Practice Address - Country:US
Practice Address - Phone:972-375-4766
Practice Address - Fax:972-228-4267
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62490101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor