Provider Demographics
NPI:1700693728
Name:WILLIAMS, TAMEKA MASSENBURG (LPC)
Entity type:Individual
Prefix:
First Name:TAMEKA
Middle Name:MASSENBURG
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 HORSESHOE RD
Mailing Address - Street 2:
Mailing Address - City:JARRATT
Mailing Address - State:VA
Mailing Address - Zip Code:23867-9046
Mailing Address - Country:US
Mailing Address - Phone:804-835-3307
Mailing Address - Fax:
Practice Address - Street 1:307 DOGWOOD LN STE B
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-1239
Practice Address - Country:US
Practice Address - Phone:434-829-6282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013909101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty