Provider Demographics
NPI:1336888262
Name:WILLLIAMS, CAYLEE-MAE JEAN
Entity type:Individual
Prefix:
First Name:CAYLEE-MAE
Middle Name:JEAN
Last Name:WILLLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 SUNCREST LOOP APT 206
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-9036
Mailing Address - Country:US
Mailing Address - Phone:707-580-2550
Mailing Address - Fax:
Practice Address - Street 1:354 ENGLENOOK DR
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-1804
Practice Address - Country:US
Practice Address - Phone:407-635-1979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-218138106S00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-22-218138OtherBCAB
FL24657OtherBOARD OF CLINICAL SOCIAL WORK, MARRIAGE & FAMILY THERAPY AND MENTAL HEALTH COUNS