Provider Demographics
NPI:1174040976
Name:WILLIAMS, ISHA D (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:ISHA
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 448
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27846-0448
Mailing Address - Country:US
Mailing Address - Phone:252-325-9373
Mailing Address - Fax:
Practice Address - Street 1:600 N SMITHWICK ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-1738
Practice Address - Country:US
Practice Address - Phone:252-325-9373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166001044106H00000X
NC1379106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist