Provider Demographics
NPI:1013382670
Name:WILLIAMS, MICHAEL V JR (MS)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:V
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:MS
Other - Prefix:MR
Other - First Name:MICHAEL
Other - Middle Name:V
Other - Last Name:WILLIAMS
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:3110 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31903-1926
Mailing Address - Country:US
Mailing Address - Phone:706-992-5312
Mailing Address - Fax:
Practice Address - Street 1:3110 CLAY ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31903-1926
Practice Address - Country:US
Practice Address - Phone:706-992-5312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health