Provider Demographics
NPI:1710427257
Name:WILLIAMS, TYRONEA (LGPC)
Entity Type:Individual
Prefix:MRS
First Name:TYRONEA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7509 HAINES CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3345
Mailing Address - Country:US
Mailing Address - Phone:240-486-5432
Mailing Address - Fax:
Practice Address - Street 1:7509 HAINES CT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3345
Practice Address - Country:US
Practice Address - Phone:240-486-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP7679101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health