Provider Demographics
NPI:1336204148
Name:WILLIAMS, CARRIE LEE (MS ALMFT)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS ALMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2583 SOROS CT
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115
Mailing Address - Country:US
Mailing Address - Phone:815-748-7602
Mailing Address - Fax:815-748-7602
Practice Address - Street 1:2583 SOROS CT
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-5800
Practice Address - Country:US
Practice Address - Phone:815-901-1070
Practice Address - Fax:815-748-7602
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000042106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist