Provider Demographics
NPI:1346336690
Name:WILLIAMS, JAMES B JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:PHD
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 26584
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32226-6584
Mailing Address - Country:US
Mailing Address - Phone:904-354-2594
Mailing Address - Fax:904-354-1963
Practice Address - Street 1:2700 FIRE FIGHTER MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-9539
Practice Address - Country:US
Practice Address - Phone:904-354-2594
Practice Address - Fax:904-354-1963
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLWI75632101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral