Provider Demographics
NPI:1891361804
Name:WILLIAMS, MARION (LPC)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:WILLIAMS
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 1:2 OLD NEW MILFORD ROAD
Mailing Address - Street 2:SUITE 1-B
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804
Mailing Address - Country:US
Mailing Address - Phone:203-775-2583
Mailing Address - Fax:203-775-2863
Practice Address - Street 1:2 OLD NEW MILFORD ROAD
Practice Address - Street 2:SUITE 1-B
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804
Practice Address - Country:US
Practice Address - Phone:203-775-2583
Practice Address - Fax:203-775-2863
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004757101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional