Provider Demographics
NPI:1255894341
Name:WILLIAMS, KATELYN (MA, NCC, LPC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 LYNNBROOK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2128
Mailing Address - Country:US
Mailing Address - Phone:210-415-0206
Mailing Address - Fax:
Practice Address - Street 1:6626 SILVERMINE DR STE 600
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78736-1786
Practice Address - Country:US
Practice Address - Phone:737-242-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-07
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76439101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional