Provider Demographics
NPI:1063152643
Name:WILLIAMS, DAWN A (CASAC-T)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CASAC-T
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 5426
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-0303
Mailing Address - Country:US
Mailing Address - Phone:631-894-8441
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 5426
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-0303
Practice Address - Country:US
Practice Address - Phone:631-894-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-31
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY37337101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)