Provider Demographics
NPI:1184221525
Name:WILLIAMS, SHAMERE (MA, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:SHAMERE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WALNUT AVENUE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-2277
Mailing Address - Country:US
Mailing Address - Phone:973-321-7803
Mailing Address - Fax:
Practice Address - Street 1:100 WALNUT AVENUE
Practice Address - Street 2:SUITE 210
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-0706
Practice Address - Country:US
Practice Address - Phone:973-321-7803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00731900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00731900OtherLPC LICENSE