Provider Demographics
NPI:1295511665
Name:RENEE WILLIAMSON BEHAVIORAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:RENEE WILLIAMSON BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:317-210-5179
Mailing Address - Street 1:PO BOX 88353
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-0353
Mailing Address - Country:US
Mailing Address - Phone:317-513-8979
Mailing Address - Fax:317-251-2403
Practice Address - Street 1:2555 55TH PL STE 210
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-3550
Practice Address - Country:US
Practice Address - Phone:317-210-5179
Practice Address - Fax:317-251-2403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty