Provider Demographics
NPI:1942318027
Name:WILLIAMS, THOMAS ALLEN (MA,LPCC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALLEN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MA,LPCC
Other - Prefix:MR
Other - First Name:THOMAS
Other - Middle Name:ALLEN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:2125 RESERVE CIR N
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3097
Mailing Address - Country:US
Mailing Address - Phone:440-282-8254
Mailing Address - Fax:
Practice Address - Street 1:1740 COOPER FOSTER PARK RD W
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-4201
Practice Address - Country:US
Practice Address - Phone:440-282-1383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE911101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional