Provider Demographics
NPI:1629618962
Name:WILLIAMS, DANICA LYNNE (MA, LAC, PMH-C)
Entity Type:Individual
Prefix:
First Name:DANICA
Middle Name:LYNNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, LAC, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 S NEBRASKA ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-4566
Mailing Address - Country:US
Mailing Address - Phone:425-931-6693
Mailing Address - Fax:
Practice Address - Street 1:1669 W INA RD STE 141
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1981
Practice Address - Country:US
Practice Address - Phone:520-795-6183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-15
Last Update Date:2023-11-27
Deactivation Date:2023-08-24
Deactivation Code:
Reactivation Date:2023-11-17
Provider Licenses
StateLicense IDTaxonomies
AZLAC-16482101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional