Provider Demographics
NPI:1982103107
Name:WILLIAMS, BUFFIE MARIE (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:BUFFIE
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 COUNTY ROAD 7727
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-5212
Mailing Address - Country:US
Mailing Address - Phone:334-372-6950
Mailing Address - Fax:
Practice Address - Street 1:95 COUNTY ROAD 7727
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-5212
Practice Address - Country:US
Practice Address - Phone:334-372-6950
Practice Address - Fax:334-372-6950
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3239101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL46-3894468Medicaid