Provider Demographics
NPI:1932727682
Name:WILLIAMS, ANGELA SHAYNA (LPC, CRC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:SHAYNA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2513 MCCAIN BOULEVARD STE 2
Mailing Address - Street 2:ROOM 273
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-2372
Mailing Address - Country:US
Mailing Address - Phone:501-416-2457
Mailing Address - Fax:
Practice Address - Street 1:6616 MAGNOLIA WAY
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2372
Practice Address - Country:US
Practice Address - Phone:501-416-2457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92330101YP2500X
ARP2205003101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional