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Individual

AMY WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC, CCFC

Contact information

Practice address
1219 GUSDORF RD STE E, TAOS, NM 87571-6499
(575) 770-9581
Mailing address
PO BOX 1293, TAOS, NM 87571-1293
(575) 770-9581

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
F18506
101YP2500X
Professional Counselor
Primary
005527
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10859519
NM
Enumeration date
01/24/2007
Last updated
11/30/2022
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