Provider Demographics
NPI:1932678463
Name:WILLIAMS, KARISSA JANAY
Entity Type:Individual
Prefix:
First Name:KARISSA
Middle Name:JANAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 COEUR CIR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71302-5047
Mailing Address - Country:US
Mailing Address - Phone:318-451-4909
Mailing Address - Fax:
Practice Address - Street 1:448 COEUR CIR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71302-5047
Practice Address - Country:US
Practice Address - Phone:318-451-4909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health