Provider Demographics
NPI:1245728435
Name:WILLIAMS, TERRI STEPHANIE (LCP)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:STEPHANIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8405 OLD BEE CAVES RD APT 1122
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8137
Mailing Address - Country:US
Mailing Address - Phone:512-796-2409
Mailing Address - Fax:
Practice Address - Street 1:8405 OLD BEE CAVES RD APT 1122
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8137
Practice Address - Country:US
Practice Address - Phone:512-796-2409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75480101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional