Provider Demographics
NPI:1316160419
Name:WILLIAMS, JAMES D
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14930 LAPLAISANCE RD
Mailing Address - Street 2:SUITE 123
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-3880
Mailing Address - Country:US
Mailing Address - Phone:734-240-3850
Mailing Address - Fax:
Practice Address - Street 1:14930 LAPLAISANCE RD
Practice Address - Street 2:SUITE 123
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-3880
Practice Address - Country:US
Practice Address - Phone:734-240-3850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012227101YM0800X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health