Provider Demographics
NPI:1689397960
Name:WILLIAMS, LUE
Entity Type:Individual
Prefix:
First Name:LUE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E BROADWAY STE 400
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3104
Mailing Address - Country:US
Mailing Address - Phone:541-357-9764
Mailing Address - Fax:541-603-9800
Practice Address - Street 1:101 E BROADWAY STE 400
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3104
Practice Address - Country:US
Practice Address - Phone:541-357-9764
Practice Address - Fax:541-603-9800
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health