Provider Demographics
NPI:1629086129
Name:WILLIAMS-ZUCCARO, GEORGIA ANN (LPC)
Entity type:Individual
Prefix:MR
First Name:GEORGIA
Middle Name:ANN
Last Name:WILLIAMS-ZUCCARO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2863 JACQUELINE LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3138
Mailing Address - Country:US
Mailing Address - Phone:409-338-8171
Mailing Address - Fax:
Practice Address - Street 1:2863 JACQUELINE LN
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3138
Practice Address - Country:US
Practice Address - Phone:409-338-8171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15527101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0289035-02Medicaid