Provider Demographics
NPI:1679694814
Name:WILLIAMS, LISA ANN (MSW, LMFT)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 DEERHURST DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3879
Mailing Address - Country:US
Mailing Address - Phone:405-364-1667
Mailing Address - Fax:
Practice Address - Street 1:624 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-3924
Practice Address - Country:US
Practice Address - Phone:405-799-3379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK657106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist