Provider Demographics
NPI:1124549225
Name:WILLIAMS, RAYMOND WELDON
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:WELDON
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 49TH ST. NORTH,
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782
Mailing Address - Country:US
Mailing Address - Phone:727-544-0044
Mailing Address - Fax:727-545-0125
Practice Address - Street 1:8800 49TH ST. NORTH, SUITE 106
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782
Practice Address - Country:US
Practice Address - Phone:727-544-0044
Practice Address - Fax:727-545-0125
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)