Provider Demographics
NPI:1447537048
Name:WARREN, WILLIAM B (NCC, LPC, MAC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:WARREN
Suffix:
Gender:M
Credentials:NCC, LPC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 889
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30683-0889
Mailing Address - Country:US
Mailing Address - Phone:706-521-3950
Mailing Address - Fax:
Practice Address - Street 1:337 S MILLEDGE AVE STE 124
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-7207
Practice Address - Country:US
Practice Address - Phone:706-521-3784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008025101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional