Provider Demographics
NPI:1134753775
Name:WILLIAMSON, LAURA (EDD, MAC, LMHC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:EDD, MAC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 116TH AVE NE STE 103
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3011
Mailing Address - Country:US
Mailing Address - Phone:206-849-6322
Mailing Address - Fax:425-462-8556
Practice Address - Street 1:1940 116TH AVE NE STE 103
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3011
Practice Address - Country:US
Practice Address - Phone:425-462-8558
Practice Address - Fax:425-462-8556
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-22
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61467761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional