Provider Demographics
NPI:1750623666
Name:WILLIAMSON, MICHELLE (MS)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6819 PASEO SANTA CRUZ
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-5757
Mailing Address - Country:US
Mailing Address - Phone:570-852-1076
Mailing Address - Fax:
Practice Address - Street 1:344 DIVISION ST STE 205
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6893
Practice Address - Country:US
Practice Address - Phone:570-852-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94588101YA0400X
CA71564106H00000X
CA98047106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)