Provider Demographics
NPI:1780133579
Name:WILLIAMS, TERESA LOUISE (ALC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:LOUISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 ARTIE ST SW STE 38
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-4732
Mailing Address - Country:US
Mailing Address - Phone:256-715-9800
Mailing Address - Fax:
Practice Address - Street 1:2705 ARTIE ST SW STE 38
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-4732
Practice Address - Country:US
Practice Address - Phone:256-715-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3802101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health