Basic Information
| Provider Information | |||||||||
| NPI: | 1619197324 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | HELEN | ||||||||
| MiddleName: | HOLMES | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1433 FAIRFIELD DR | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787587244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124918444 | ||||||||
| FaxNumber: | 5124910226 | ||||||||
| Practice Location | |||||||||
| Address1: | 1433 FAIRFIELD DR | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787587244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124918444 | ||||||||
| FaxNumber: | 5124910226 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2007 | ||||||||
| LastUpdateDate: | 06/30/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 14625 | TX | Y | Behavioral Health & Social Service Providers | Social Worker |
ID Information
| ID | Type | State | Issuer | Description | 027752702 | 05 | TX | MEDICAID |