Provider Demographics
NPI:1013200377
Name:PHILLIPS, WILLIAM J (MSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:J
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-8554
Mailing Address - Country:US
Mailing Address - Phone:352-397-5911
Mailing Address - Fax:
Practice Address - Street 1:1731 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-8554
Practice Address - Country:US
Practice Address - Phone:352-397-5911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker