Provider Demographics
NPI:1750038626
Name:WILLIAMS, AMANDA KATE (LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KATE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 GOLDFINCH DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-7203
Mailing Address - Country:US
Mailing Address - Phone:303-587-0530
Mailing Address - Fax:
Practice Address - Street 1:111 GOLDFINCH DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35756-7203
Practice Address - Country:US
Practice Address - Phone:303-587-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CO13962101YP2500X
AL4347101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional