| Renee Williamson Behavioral Health Services, Llc | |
|
2555 55th Pl Ste 210 Indianapolis IN 46220-3550 | |
| (317) 210-5179 | |
| (317) 251-2403 |
| Full Name | Renee Williamson Behavioral Health Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 2555 55th Pl Ste 210, Indianapolis, Indiana |
| Authorized Official Name and Position | Gwendolyn Renee Williamson (THERAPIST) |
| Authorized Official Contact | 3172105179 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renee Williamson Behavioral Health Services, Llc Po Box 88353 Indianapolis IN 46208-0353 Ph: (317) 513-8979 | Renee Williamson Behavioral Health Services, Llc 2555 55th Pl Ste 210 Indianapolis IN 46220-3550 Ph: (317) 210-5179 |
| NPI Number | 1295511665 |
|---|---|
| Provider Enumeration Date | 09/01/2023 |
| Last Update Date | 09/01/2023 |
| Certification Date | 09/01/2023 |
| Medicare PECOS PAC ID | 9032560529 |
|---|---|
| Medicare Enrollment ID | O20240109002993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295511665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Gwendolyn Renee Williamson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457951832 PECOS PAC ID: 4981015294 Enrollment ID: I20240109003119 |
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