Provider Demographics
NPI:1538704051
Name:WILLIAMS, HATTIE M (LPCA)
Entity Type:Individual
Prefix:
First Name:HATTIE
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 VAN GOGH TRL
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-9356
Mailing Address - Country:US
Mailing Address - Phone:704-451-2847
Mailing Address - Fax:
Practice Address - Street 1:156 VAN GOGH TRL
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-9356
Practice Address - Country:US
Practice Address - Phone:980-229-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2023-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional