Provider Demographics
NPI:1609318518
Name:WILLIAMS, ALISSA (CDCA)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 KELLY CT
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-6024
Mailing Address - Country:US
Mailing Address - Phone:513-941-4999
Mailing Address - Fax:513-941-7555
Practice Address - Street 1:7597 BRIDGETOWN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-2019
Practice Address - Country:US
Practice Address - Phone:513-941-4999
Practice Address - Fax:513-941-7555
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH151627101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)