Provider Demographics
NPI:1124508205
Name:WILLIAMS, ROBERT (LPCMH, LCADC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LPCMH, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BALL FARM WAY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-2021
Mailing Address - Country:US
Mailing Address - Phone:201-259-8823
Mailing Address - Fax:
Practice Address - Street 1:16 BALL FARM WAY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2021
Practice Address - Country:US
Practice Address - Phone:201-259-8823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00208800101YA0400X
DEPC-0011232101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)