Provider Demographics
NPI:1972061919
Name:WILLIAMS, MICHELLE (LPC, LCADC, CCS)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC, LCADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1856
Mailing Address - Country:US
Mailing Address - Phone:609-926-0407
Mailing Address - Fax:
Practice Address - Street 1:805 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1856
Practice Address - Country:US
Practice Address - Phone:609-926-0407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor