Provider Demographics
NPI:1811875511
Name:WILLIAMS, MADISON (LPC)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:X
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MOUNT ELON CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:SC
Mailing Address - Zip Code:29061-9267
Mailing Address - Country:US
Mailing Address - Phone:803-354-8073
Mailing Address - Fax:
Practice Address - Street 1:419 SE MAIN ST
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-2673
Practice Address - Country:US
Practice Address - Phone:803-354-8073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8675101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional