1063530285 NPI number — MS. ALICE MAUREEN WILLIAMS LPC, LMFT

Table of content: MS. ALICE MAUREEN WILLIAMS LPC, LMFT (NPI 1063530285)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063530285 NPI number — MS. ALICE MAUREEN WILLIAMS LPC, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
ALICE
Provider Middle Name:
MAUREEN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPC, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063530285
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2850 CEDAR HILLS BLVD.
Provider Second Line Business Mailing Address:
BOX 137
Provider Business Mailing Address City Name:
BEAVERTON
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-227-2150
Provider Business Mailing Address Fax Number:
888-972-8764

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12655 SW CENTER STREET
Provider Second Line Business Practice Location Address:
SUITE 470
Provider Business Practice Location Address City Name:
BEAVERTON
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-227-2150
Provider Business Practice Location Address Fax Number:
888-972-8764
Provider Enumeration Date:
03/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  40724 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: T0596 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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