Provider Demographics
NPI:1851505739
Name:WILLIAMS, CHERYL LAVERN (CAC II)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LAVERN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5690 IRONSTONE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-5790
Mailing Address - Country:US
Mailing Address - Phone:706-442-9527
Mailing Address - Fax:
Practice Address - Street 1:2100 COMER AVENUE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906
Practice Address - Country:US
Practice Address - Phone:706-596-5764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005015101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional