Provider Demographics
NPI:1891357661
Name:WILLIAMSON, KENYA (LPC)
Entity Type:Individual
Prefix:
First Name:KENYA
Middle Name:
Last Name:WILLIAMSON
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 1:5601 BRIDGE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-2355
Mailing Address - Country:US
Mailing Address - Phone:682-214-0607
Mailing Address - Fax:682-232-0611
Practice Address - Street 1:5601 BRIDGE ST STE 300
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-2355
Practice Address - Country:US
Practice Address - Phone:682-214-0607
Practice Address - Fax:682-232-0611
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67726101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional