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Provider Information for 1710417084


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Dr. MARIA A WILLIAMS Ph.D., LMHC, SUDP


Sex: Female

NPI: 1710417084
Last Updated: 2024-02-09
Certification Date: 2024-02-09

Details

NameValue
NPI1710417084
Enumeration Date2017-06-19
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 5900 BALUSTRADE BLVD SE
LACEY, WA 98513-5075
United States

Phone: 253-279-2217 | Fax:
 
Primary Practice Address 5900 BALUSTRADE BLVD SE
LACEY, WA 98513-5075
United States

Phone: 253-279-2217 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)WA60728563
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)WACP60925562
Yes 101YM0800X - Counselor - Mental HealthWALH61066272