Doctor Name: | SAMUEL WILLIAMS |
NPI Number: | 1013346683 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | LPC007518 |
Business Practice Address: | 511 W Forsyth St Suite F Americus, GA - 317093465 |
Business Phone Number: | 2295916241 |
Business Fax Number: | 2299280467 |
Mailing Address: | 103 Mims Cir, AMERICUS |
State: | GA |
Postal Code: | 317092707 |
Phone Number: | 2295916241 |
Fax Number: | 2299280467 |
NPI Enumeration Date: | 11/05/2013 |
NPI Last Update Date: | 12/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC007518 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |