Provider Demographics
NPI:1225570377
Name:WILLIAMS, ELVIRA
Entity Type:Individual
Prefix:MS
First Name:ELVIRA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 SHAKER HEIGHTS RD
Mailing Address - Street 2:APARTMENT 33
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-5314
Mailing Address - Country:US
Mailing Address - Phone:845-665-1728
Mailing Address - Fax:
Practice Address - Street 1:91 SHAKER HEIGHTS RD
Practice Address - Street 2:APARTMENT 33
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-5314
Practice Address - Country:US
Practice Address - Phone:845-665-1728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)