Provider Demographics
NPI:1962545491
Name:WILLIAMS, MATTHEW MICHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:MICHAEL
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 CACTUS LN
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-7686
Mailing Address - Country:US
Mailing Address - Phone:254-781-2027
Mailing Address - Fax:254-781-2028
Practice Address - Street 1:1711 E CENTRAL TEXAS EXPY STE 106B
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-9145
Practice Address - Country:US
Practice Address - Phone:254-781-2027
Practice Address - Fax:254-781-2028
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36045103TC0700X, 103TC0700X, 103TC0700X
TX64778101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional