Provider Demographics
NPI:1669737722
Name:WILLIAMS, ADAM DONALD (LPC)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:DONALD
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-3008
Mailing Address - Country:US
Mailing Address - Phone:434-465-5252
Mailing Address - Fax:
Practice Address - Street 1:30 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-3008
Practice Address - Country:US
Practice Address - Phone:540-483-5044
Practice Address - Fax:540-483-0583
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005256101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health