Provider Demographics
NPI:1922264589
Name:WILLIAMS, LISA N (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:N
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-3731
Mailing Address - Country:US
Mailing Address - Phone:404-626-8706
Mailing Address - Fax:
Practice Address - Street 1:405 MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-3731
Practice Address - Country:US
Practice Address - Phone:404-626-8706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health