Provider Demographics
NPI:1689921645
Name:WILLIAMS, HEIDI (MA, LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 ROGERS ST NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-5343
Mailing Address - Country:US
Mailing Address - Phone:360-791-5410
Mailing Address - Fax:
Practice Address - Street 1:147 ROGERS ST NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5343
Practice Address - Country:US
Practice Address - Phone:360-791-5410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008020101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health