Provider Demographics
NPI:1891493920
Name:WILLIAMS, LINDSAY (EDS)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 YACHT HARBOR CT
Mailing Address - Street 2:
Mailing Address - City:ISLE OF PALMS
Mailing Address - State:SC
Mailing Address - Zip Code:29451-2600
Mailing Address - Country:US
Mailing Address - Phone:616-405-8551
Mailing Address - Fax:
Practice Address - Street 1:9 YACHT HARBOR CT
Practice Address - Street 2:
Practice Address - City:ISLE OF PALMS
Practice Address - State:SC
Practice Address - Zip Code:29451-2600
Practice Address - Country:US
Practice Address - Phone:616-405-8551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISP0000438103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool