Provider Demographics
NPI:1740405034
Name:WILLIAMS, LINDA JOYCE (MA)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:JOYCE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 N YORK ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-3536
Mailing Address - Country:US
Mailing Address - Phone:303-861-2004
Mailing Address - Fax:303-292-3252
Practice Address - Street 1:3840 N YORK ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3536
Practice Address - Country:US
Practice Address - Phone:303-861-2004
Practice Address - Fax:303-299-9064
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3402101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO014664Medicaid
CO3402OtherSTATE IDENTIFICATION