Provider Demographics
NPI:1073764833
Name:WILLIAMS, EDWARD JAMES (MSW,LCSW)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JAMES
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3245 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7809
Mailing Address - Country:US
Mailing Address - Phone:907-364-4499
Mailing Address - Fax:907-364-4499
Practice Address - Street 1:3245 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-364-4499
Practice Address - Fax:907-364-1539
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical