Provider Demographics
NPI:1770243511
Name:WILLIAMS, KATRINA RAJA'NAE (LPC-R)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:RAJA'NAE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3657 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2214
Mailing Address - Country:US
Mailing Address - Phone:757-371-6116
Mailing Address - Fax:
Practice Address - Street 1:900 GRANBY ST STE 105
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2531
Practice Address - Country:US
Practice Address - Phone:757-447-7382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014484101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty