Provider Demographics
NPI:1982450532
Name:WILLIAMS, LARRY J (LPC)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5522 WOODMANSEE WAY
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-5916
Mailing Address - Country:US
Mailing Address - Phone:513-238-7494
Mailing Address - Fax:513-777-7115
Practice Address - Street 1:5522 WOODMANSEE WAY
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-5916
Practice Address - Country:US
Practice Address - Phone:513-238-7494
Practice Address - Fax:513-777-7115
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2305531101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health