Provider Demographics
NPI:1851265573
Name:WILLIAMS, MATTHEW (MS, RMHCI)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MS, RMHCI
Other - Prefix:
Other - First Name:MATT
Other - Middle Name:
Other - Last Name:COLACIELLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1601-1 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32206-4453
Mailing Address - Country:US
Mailing Address - Phone:904-701-4895
Mailing Address - Fax:
Practice Address - Street 1:2309 PARK ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4317
Practice Address - Country:US
Practice Address - Phone:904-701-4895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-04
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH28445101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health