Provider Demographics
NPI:1982911806
Name:WILLIAMS, CAROL EILENE (MA MFT)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:EILENE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 MARSH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-1698
Mailing Address - Country:US
Mailing Address - Phone:775-322-4003
Mailing Address - Fax:775-322-4017
Practice Address - Street 1:210 MARSH AVE STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-1698
Practice Address - Country:US
Practice Address - Phone:775-322-4003
Practice Address - Fax:775-322-4017
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0889106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist