Provider Demographics
NPI:1306687884
Name:WILLIAMS, JAMIE (MA, MPH)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 VAN VOORHIS RD APT 1111
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2558
Mailing Address - Country:US
Mailing Address - Phone:304-992-1526
Mailing Address - Fax:
Practice Address - Street 1:1005 WHITE WILLOW WAY
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-6119
Practice Address - Country:US
Practice Address - Phone:304-212-7238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV101YM0800X
WV926101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health