Provider Demographics
NPI:1841661295
Name:WILLIAMS, MARIANNE BERGMANN (LMHC)
Entity type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:BERGMANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3275 HAVILAND CT
Mailing Address - Street 2:#201
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-1888
Mailing Address - Country:US
Mailing Address - Phone:727-744-3145
Mailing Address - Fax:
Practice Address - Street 1:3275 HAVILAND CT
Practice Address - Street 2:#201
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1888
Practice Address - Country:US
Practice Address - Phone:727-744-3145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH11777101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health