Provider Demographics
NPI:1043016645
Name:WILLIAMS, JESSICA (LMHC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10531 WILDERNESS LN
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32534-9787
Mailing Address - Country:US
Mailing Address - Phone:850-572-8660
Mailing Address - Fax:
Practice Address - Street 1:233 E MAIN ST STE 401
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-5045
Practice Address - Country:US
Practice Address - Phone:866-484-8218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH24872101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health