Provider Demographics
NPI:1750561403
Name:GRAHAM-WILLIAMS, ANGELA ELAINE (LPC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:ELAINE
Last Name:GRAHAM-WILLIAMS
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 1:6136 S 30TH ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-9344
Mailing Address - Country:US
Mailing Address - Phone:504-273-1556
Mailing Address - Fax:
Practice Address - Street 1:6136 S 30TH ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-9344
Practice Address - Country:US
Practice Address - Phone:269-209-5717
Practice Address - Fax:269-342-9891
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010353103T00000X
MI6401013292101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist