Suzette Delicia Williams, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC011523 Issued in GA

Practice address

147 Forrest Park LN
Dallas, GA 30157-9667

Phone

(470) 985-6858

NPI assigned

May 26, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Suzett Delicia Blount Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Boundless Love Psychotherapy, LLC

  • Professional Counselor
  • Dallas, GA
  • NPI 1588253280
  NPD Authorized official
• Life Poured Out Services, Inc.

  • Community/Behavioral Health Agency
  • Hiram, GA
  • NPI 1174115539

  Professional

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735084800000",
    "number": "1942823901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 STEEPLE CHASE TRL",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301328305",
            "telephone_number": "470-985-6858",
            "fax_number": "678-669-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 FORREST PARK LN",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301579667",
            "telephone_number": "470-985-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SUZETTE",
        "middle_name": "DELICIA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2024-12-25",
        "certification_date": "2024-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC011523",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC011523",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC011523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LPC011523",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.familytherapistdallas.com/",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "34 Steeple Chase Trl",
            "city": "Dallas",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301328305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.familytherapistdallas.com/",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "34 Steeple Chase Trl",
            "city": "Dallas",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301328305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUZETT",
            "last_name": "BLOUNT",
            "middle_name": "DELICIA",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dorothy P Williams, LCSW
• Euphrates Soyini Elise Williams, DVM
• Ivetta Williams, RN
• Lisa Michelle Williams, PHARMD
• Shamia Nikila Williams, LMSW
• Tyleesha Williams
• Linda Suzanne Williamson-Kersey, LMSW, CSW, CADC LL,
• Dorella Wilson-Woods
• Jordan Wilson
• Martin Ralph Wilson, D.C.

• Professional Counselor in Dallas, GA
• Providers in Dallas, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.