Provider Demographics
NPI:1154210706
Name:WILLIAMS, NATHAN DENTON (MA, RBT)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:DENTON
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MA, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 SADDLE BRK
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-5637
Mailing Address - Country:US
Mailing Address - Phone:270-293-6550
Mailing Address - Fax:
Practice Address - Street 1:960 MADDOX SIMPSON PKWY
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37090-0751
Practice Address - Country:US
Practice Address - Phone:615-444-1251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-21-166857106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician