Provider Demographics
NPI:1275742249
Name:WILLIAMS, JONATHAN
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
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:PO BOX 1088
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-5088
Mailing Address - Country:US
Mailing Address - Phone:256-841-8191
Mailing Address - Fax:
Practice Address - Street 1:7027 OLD MADISON PIKE NW STE 108
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-2369
Practice Address - Country:US
Practice Address - Phone:256-841-8191
Practice Address - Fax:256-705-6356
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)