Provider Demographics
NPI:1801236104
Name:WILLIAMSON, SALLY A (LPC)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:A
Last Name:WILLIAMSON
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 1:868 HALF MOON TRL APT 204
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-8110
Mailing Address - Country:US
Mailing Address - Phone:843-655-9297
Mailing Address - Fax:843-673-9223
Practice Address - Street 1:120 CHADWICK SQUARE CT STE C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-3200
Practice Address - Country:US
Practice Address - Phone:828-697-4187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5497101YP2500X
SC5693101YP2500X
NC13467101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional