Provider Demographics
NPI:1548546625
Name:WILLIAMS, SHELLIE LUCILLE (LPC, LCDC, MA, M ED)
Entity type:Individual
Prefix:MRS
First Name:SHELLIE
Middle Name:LUCILLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC, LCDC, MA, M ED
Other - Prefix:MRS
Other - First Name:SHELLIE
Other - Middle Name:LUCILLE
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1221 BLUFFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-3501
Mailing Address - Country:US
Mailing Address - Phone:214-558-9018
Mailing Address - Fax:
Practice Address - Street 1:1221 BLUFFVIEW DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-3501
Practice Address - Country:US
Practice Address - Phone:214-558-9018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11033101YA0400X
TX101YS0200X
TX83060101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool