Provider Demographics
NPI:1992114466
Name:WILLIAMS, ZACERI (MSED, QMHP)
Entity type:Individual
Prefix:MR
First Name:ZACERI
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MSED, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 W 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46408-4438
Mailing Address - Country:US
Mailing Address - Phone:219-688-6487
Mailing Address - Fax:
Practice Address - Street 1:1510 W 47TH AVE
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46408-4438
Practice Address - Country:US
Practice Address - Phone:219-688-6487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor