Provider Demographics
NPI:1811210404
Name:WILLIAMS, PAMELA K (MS, LCPC)
Entity Type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:K
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12043 S INDIANA AVE
Mailing Address - Street 2:APT. 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-6723
Mailing Address - Country:US
Mailing Address - Phone:773-979-6637
Mailing Address - Fax:
Practice Address - Street 1:12043 S INDIANA AVE
Practice Address - Street 2:APT. 2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-6723
Practice Address - Country:US
Practice Address - Phone:773-979-6637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional