Provider Demographics
NPI:1922260918
Name:WILLIAMS, PAMELA WELLS (LPC/MHSP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:WELLS
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 TROTWOOD AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4750
Mailing Address - Country:US
Mailing Address - Phone:931-388-9668
Mailing Address - Fax:931-223-6047
Practice Address - Street 1:1324 TROTWOOD AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4750
Practice Address - Country:US
Practice Address - Phone:931-388-9668
Practice Address - Fax:931-223-6047
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000001864101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health