Provider Demographics
NPI:1760515019
Name:WILLIAMSON, DENISE CAROLYN I (LMFT)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:CAROLYN
Last Name:WILLIAMSON
Suffix:I
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:PISMO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93448-0035
Mailing Address - Country:US
Mailing Address - Phone:805-245-2012
Mailing Address - Fax:
Practice Address - Street 1:1411 MARSH ST
Practice Address - Street 2:S-108
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2957
Practice Address - Country:US
Practice Address - Phone:805-245-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82446106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist