Provider Demographics
NPI:1255581492
Name:WILLIAMS, TERESA SHONTELL (MS,RSAP, AAPS)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:SHONTELL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS,RSAP, AAPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 NW MILL COURT
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-3485
Mailing Address - Country:US
Mailing Address - Phone:816-225-5343
Mailing Address - Fax:816-225-5343
Practice Address - Street 1:506 NW MILL COURT
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-3485
Practice Address - Country:US
Practice Address - Phone:816-225-5343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO3593101YA0400X
KS101YA0400X
MO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)