Provider Demographics
NPI:1811482409
Name:WILLIAMS, NECHALAE HAGANS (LPCA)
Entity type:Individual
Prefix:
First Name:NECHALAE
Middle Name:HAGANS
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:MRS
Other - First Name:NECHA
Other - Middle Name:LAE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCA
Mailing Address - Street 1:130 SOUTHERN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-3223
Mailing Address - Country:US
Mailing Address - Phone:606-679-4782
Mailing Address - Fax:
Practice Address - Street 1:259 PARKERS MILL RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-3152
Practice Address - Country:US
Practice Address - Phone:606-679-7348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174525101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health