Provider Demographics
NPI:1437724077
Name:WILLIAMS, JAMARIUS ISIAH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JAMARIUS
Middle Name:ISIAH
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3603 GATEWAY DR APT 2D
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-5010
Mailing Address - Country:US
Mailing Address - Phone:843-610-5059
Mailing Address - Fax:
Practice Address - Street 1:425 W WASHINGTON ST STE 4
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5320
Practice Address - Country:US
Practice Address - Phone:757-809-5376
Practice Address - Fax:757-401-6912
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040128511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical