Provider Demographics
NPI:1104445543
Name:WILLIAMS, CHAVON CECILY (LPC)
Entity type:Individual
Prefix:
First Name:CHAVON
Middle Name:CECILY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4006 REDWOOD HILL CT
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-8726
Mailing Address - Country:US
Mailing Address - Phone:832-901-4846
Mailing Address - Fax:
Practice Address - Street 1:4006 REDWOOD HILL CT
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-8726
Practice Address - Country:US
Practice Address - Phone:832-901-4846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX78009OtherLPC