Provider Demographics
NPI:1144950031
Name:WILLIAMS, VALERIE LEANNE (LCDC)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:LEANNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15221 MEREDITH LN
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-7191
Mailing Address - Country:US
Mailing Address - Phone:979-492-9648
Mailing Address - Fax:
Practice Address - Street 1:1651 ROCK PRAIRIE RD STE 101
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8652
Practice Address - Country:US
Practice Address - Phone:979-599-9580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14475101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)