Provider Demographics
NPI:1356949259
Name:WILLIAMS, ROSHAWN C (QBHP)
Entity type:Individual
Prefix:
First Name:ROSHAWN
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:QBHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 W 3RD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-2221
Mailing Address - Country:US
Mailing Address - Phone:501-379-4261
Mailing Address - Fax:844-605-1515
Practice Address - Street 1:109 MAGNOLIA COURT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-5365
Practice Address - Country:US
Practice Address - Phone:501-533-4563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health