Provider Demographics
NPI:1538451083
Name:WILLLIAMS, RALPH BERNARD (MA, MS, LAPC)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:BERNARD
Last Name:WILLLIAMS
Suffix:
Gender:M
Credentials:MA, MS, LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2691 OSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-2840
Mailing Address - Country:US
Mailing Address - Phone:770-856-3011
Mailing Address - Fax:
Practice Address - Street 1:6188 HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-1028
Practice Address - Country:US
Practice Address - Phone:770-856-3011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC002823101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)