Provider Demographics
NPI:1386027001
Name:WILLIAMS, HUBERT JR (CSAC-R)
Entity Type:Individual
Prefix:MR
First Name:HUBERT
Middle Name:
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:CSAC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BRADFORD AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-5401
Mailing Address - Country:US
Mailing Address - Phone:910-222-6067
Mailing Address - Fax:910-485-4752
Practice Address - Street 1:109 BRADFORD AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-5401
Practice Address - Country:US
Practice Address - Phone:910-222-6067
Practice Address - Fax:910-485-4752
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCSAC-21031101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)