Provider Demographics
NPI:1205041803
Name:WILLIAMS, AUDREY RENAE (LPC)
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:RENAE
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 1:2225 HEATHER GLEN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-2319
Mailing Address - Country:US
Mailing Address - Phone:469-955-7630
Mailing Address - Fax:
Practice Address - Street 1:2225 HEATHER GLEN DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-2319
Practice Address - Country:US
Practice Address - Phone:469-955-7630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional