Provider Demographics
NPI:1043056724
Name:WILLIAMS, COURTNEY JUKEL (LPCA)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:JUKEL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SENIOR WAY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6080
Mailing Address - Country:US
Mailing Address - Phone:888-918-2415
Mailing Address - Fax:888-489-1793
Practice Address - Street 1:600 SENIOR WAY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6080
Practice Address - Country:US
Practice Address - Phone:888-918-2415
Practice Address - Fax:888-489-1793
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8910101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health