Provider Demographics
NPI:1568791713
Name:WILLIAMS, GERALDINE O (LPC)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:O
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:396 SUNRISE CIR
Mailing Address - Street 2:
Mailing Address - City:SEAGOVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75159-2045
Mailing Address - Country:US
Mailing Address - Phone:972-287-4128
Mailing Address - Fax:
Practice Address - Street 1:2727 AL LIPSCOMB WAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-2234
Practice Address - Country:US
Practice Address - Phone:972-502-4220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20170101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional