Provider Demographics
NPI:1013376722
Name:WILLIAMS, J DAWSON (DMIN, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:J DAWSON
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DMIN, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1084
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72078-1084
Mailing Address - Country:US
Mailing Address - Phone:501-837-9723
Mailing Address - Fax:
Practice Address - Street 1:112 FAIR OAKS DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-4280
Practice Address - Country:US
Practice Address - Phone:501-837-9723
Practice Address - Fax:877-775-2230
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-23
Last Update Date:2022-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1604051101YP2500X, 101YP1600X, 101YM0800X
ARM1604004106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist