Provider Demographics
NPI:1609105683
Name:WILLIAMS, JESSICA A (LMHC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:A
Other - Last Name:METZLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:25932 TERRAWOOD LOOP
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-5731
Mailing Address - Country:US
Mailing Address - Phone:813-486-6560
Mailing Address - Fax:
Practice Address - Street 1:25344 WESLEY CHAPEL BLVD
Practice Address - Street 2:STE. 101
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-2658
Practice Address - Country:US
Practice Address - Phone:813-421-5762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-21
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 14029101YM0800X
101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool