Provider Demographics
NPI:1467625905
Name:WILLIAMS, BIRNIE EDWARD II (MSW, LICSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:BIRNIE
Middle Name:EDWARD
Last Name:WILLIAMS
Suffix:II
Gender:M
Credentials:MSW, LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SUGARLOAF ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:SOUTH DEERFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01373-1144
Mailing Address - Country:US
Mailing Address - Phone:413-575-5372
Mailing Address - Fax:
Practice Address - Street 1:270 BENTON DR
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-3233
Practice Address - Country:US
Practice Address - Phone:413-567-9993
Practice Address - Fax:413-244-2650
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1227671041C0700X
MA1139431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA002178201Medicare PIN