Provider Demographics
NPI:1932889268
Name:WILLIAMS, RIVER (PHD)
Entity type:Individual
Prefix:
First Name:RIVER
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:
Other - Last Name:WAITS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4435 O ST STE 211
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1864
Mailing Address - Country:US
Mailing Address - Phone:402-489-2218
Mailing Address - Fax:402-489-3666
Practice Address - Street 1:4435 O ST STE 211
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1864
Practice Address - Country:US
Practice Address - Phone:402-489-2218
Practice Address - Fax:402-489-3666
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13435101YM0800X
NE1195103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health