Provider Demographics
NPI:1528578358
Name:WILLIAMS, CYNTHIA ELIZABETH (LLPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ELIZABETH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20810 MELROSE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5680
Mailing Address - Country:US
Mailing Address - Phone:248-403-6488
Mailing Address - Fax:
Practice Address - Street 1:1150 E LANTZ ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48203-1376
Practice Address - Country:US
Practice Address - Phone:313-368-4267
Practice Address - Fax:313-368-4800
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006531101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor