Provider Demographics
NPI:1427113372
Name:GEER-WILLIAMS, CAROL RENAE (PHD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:RENAE
Last Name:GEER-WILLIAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 MAIN ST
Mailing Address - Street 2:SUITE 143
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4354
Mailing Address - Country:US
Mailing Address - Phone:301-490-0778
Mailing Address - Fax:301-498-4663
Practice Address - Street 1:585 MAIN ST
Practice Address - Street 2:SUITE 143
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4354
Practice Address - Country:US
Practice Address - Phone:301-490-0778
Practice Address - Fax:301-498-4663
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02331103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD864103Medicare PIN