Provider Demographics
NPI:1457802373
Name:WILLIAMS, DELIA HARRIET (LPC)
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:HARRIET
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:D
Other - Middle Name:HARRIET
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1637 ATHENS HWY
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-1768
Mailing Address - Country:US
Mailing Address - Phone:678-344-8268
Mailing Address - Fax:678-922-7762
Practice Address - Street 1:1637 ATHENS HWY
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-1768
Practice Address - Country:US
Practice Address - Phone:678-344-8268
Practice Address - Fax:678-922-7762
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006010101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional