Provider Demographics
NPI:1598845539
Name:WILLIAMS, MEGAN J (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17661 US 84/285
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87506-2779
Mailing Address - Country:US
Mailing Address - Phone:505-455-0555
Mailing Address - Fax:
Practice Address - Street 1:17661 US 84/285
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87506-2779
Practice Address - Country:US
Practice Address - Phone:505-455-0555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0090631101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM600191OtherVALUE OPTIONS