Provider Demographics
NPI:1518400332
Name:WILLIAMS, MELVINA LA FAYE
Entity Type:Individual
Prefix:
First Name:MELVINA
Middle Name:LA FAYE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WARDEN ST
Mailing Address - Street 2:PO BOX 516
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-2442
Mailing Address - Country:US
Mailing Address - Phone:318-680-5173
Mailing Address - Fax:318-878-3259
Practice Address - Street 1:506 HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:STERLINGTON
Practice Address - State:LA
Practice Address - Zip Code:71280
Practice Address - Country:US
Practice Address - Phone:318-598-5040
Practice Address - Fax:844-270-1958
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health