Provider Demographics
NPI:1225581770
Name:WILLIAMS, BRIAN JR (MA)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1148 E ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4068
Mailing Address - Country:US
Mailing Address - Phone:970-472-4133
Mailing Address - Fax:
Practice Address - Street 1:1148 E ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4068
Practice Address - Country:US
Practice Address - Phone:970-472-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health