Jacqueline Mary Williston, LPC, LCDC

NPI #1780305102 in Azle, Texas

Provider Information

NPI Number: 1780305102
Entity Type: Individual
Name: Jacqueline Mary Williston, LPC, LCDC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: LPC, LCDC
Enumeration Date: Sep 5, 2022
Last Updated: Sep 5, 2022

Practice Location

Address: 173 W MAIN ST STE 6
City: Azle
State: Texas
ZIP Code: 76020-3117
Phone: (817) 381-2290

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Professional — Professional	101YP2500X	Primary

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