Provider Demographics
NPI:1629010897
Name:WILLIAMS, DAVID KECK (MA,LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:KECK
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MA,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 NW 141ST ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1917
Mailing Address - Country:US
Mailing Address - Phone:405-749-2188
Mailing Address - Fax:405-755-6707
Practice Address - Street 1:9636 N MAY AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-2727
Practice Address - Country:US
Practice Address - Phone:405-749-2188
Practice Address - Fax:405-755-6707
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK507101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health