Provider Demographics
NPI:1811628290
Name:WILLIAMS, TIFFANY (MA, LPCA)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, LPCA
Other - Prefix:MS
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPCA
Mailing Address - Street 1:3614 FERNGLADE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-2921
Mailing Address - Country:US
Mailing Address - Phone:346-278-6418
Mailing Address - Fax:
Practice Address - Street 1:4201 CYPRESS CREEK PKWY STE 540
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3458
Practice Address - Country:US
Practice Address - Phone:346-278-6418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88285101YM0800X
TX82885101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health