Provider Demographics
NPI:1679665079
Name:WILLIAMS COUNSELING LLC
Entity Type:Organization
Organization Name:WILLIAMS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC NCC
Authorized Official - Phone:405-812-5934
Mailing Address - Street 1:824 ANNIE COURT
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4236
Mailing Address - Country:US
Mailing Address - Phone:405-812-5934
Mailing Address - Fax:405-364-2697
Practice Address - Street 1:824 ANNIE COURT
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-4236
Practice Address - Country:US
Practice Address - Phone:405-812-5934
Practice Address - Fax:405-364-2697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2681101YP2500X, 320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental IllnessGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100644560AMedicaid