Provider Demographics
NPI:1336921980
Name:WILLIAMS, MICHAEL (PHD, MA, NCC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHD, MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6927 N GREENVIEW AVE # 2D
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-3461
Mailing Address - Country:US
Mailing Address - Phone:773-576-8193
Mailing Address - Fax:
Practice Address - Street 1:6927 N GREENVIEW AVE # 2D
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-3461
Practice Address - Country:US
Practice Address - Phone:773-576-8193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health