Provider Demographics
NPI:1013146521
Name:WILLIAMS, MARJORIE A (MC, LISAC, LPC)
Entity type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MC, LISAC, LPC
Other - Prefix:
Other - First Name:MARGIE
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MC, LISAC, LPC
Mailing Address - Street 1:7315 N ORACLE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-6319
Mailing Address - Country:US
Mailing Address - Phone:520-404-7700
Mailing Address - Fax:520-579-2597
Practice Address - Street 1:7315 N ORACLE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-6319
Practice Address - Country:US
Practice Address - Phone:520-404-7700
Practice Address - Fax:520-579-2597
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11727101YA0400X
AZ12393101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)