Provider Demographics
NPI:1043943004
Name:WILLIAMS, MEREDITH DAWN (LPC-CANDIDATE)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:DAWN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC-CANDIDATE
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:DAWN
Other - Last Name:BAMBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1430 HARRIS ST NW
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-1455
Mailing Address - Country:US
Mailing Address - Phone:580-644-5791
Mailing Address - Fax:
Practice Address - Street 1:821 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-4526
Practice Address - Country:US
Practice Address - Phone:580-224-2830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health