Provider Demographics
NPI:1841368446
Name:WILLIAMS, LISA ALLEN (MED, LPC)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ALLEN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 SUMTER STREET
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2910
Mailing Address - Country:US
Mailing Address - Phone:803-296-5879
Mailing Address - Fax:803-296-5061
Practice Address - Street 1:1501 SUMTER STREET
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2910
Practice Address - Country:US
Practice Address - Phone:803-296-5879
Practice Address - Fax:803-296-5061
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4756101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional