Provider Demographics
NPI:1386017309
Name:WILLIAMS, MILTON (LCA097)
Entity Type:Individual
Prefix:MR
First Name:MILTON
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LCA097
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CORAL BERRY CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4613
Mailing Address - Country:US
Mailing Address - Phone:443-413-7711
Mailing Address - Fax:
Practice Address - Street 1:20 CORAL BERRY CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4613
Practice Address - Country:US
Practice Address - Phone:443-413-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional