Provider Demographics
NPI:1114434610
Name:WILLIAMS, HAROLD (MHS,LCADC,CCS,CSW)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MHS,LCADC,CCS,CSW
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 20
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08093-0020
Mailing Address - Country:US
Mailing Address - Phone:856-637-3144
Mailing Address - Fax:
Practice Address - Street 1:227 BROADWAY
Practice Address - Street 2:
Practice Address - City:WESTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08093-1151
Practice Address - Country:US
Practice Address - Phone:856-637-3144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-05
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00061200101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)