Provider Demographics
NPI:1912719923
Name:WILLIAMS, WALTER ERNEST JR (LPCC)
Entity type:Individual
Prefix:MR
First Name:WALTER
Middle Name:ERNEST
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12815 WOODSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-2532
Mailing Address - Country:US
Mailing Address - Phone:312-480-1973
Mailing Address - Fax:
Practice Address - Street 1:12815 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-2532
Practice Address - Country:US
Practice Address - Phone:312-480-1973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-25
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007860101YP2500X
OHE.2404186101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional