Provider Demographics
NPI:1730482787
Name:WILLIAMS, LUCILLE (PHD, LSSP, LPC)
Entity type:Individual
Prefix:DR
First Name:LUCILLE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD, LSSP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 N CHAPARRAL ST STE 215
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78401-2008
Mailing Address - Country:US
Mailing Address - Phone:361-549-6972
Mailing Address - Fax:361-888-4955
Practice Address - Street 1:921 N CHAPARRAL ST STE 215
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-2008
Practice Address - Country:US
Practice Address - Phone:361-549-6972
Practice Address - Fax:361-888-4955
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65034101YP2500X
TX31954103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool