Provider Demographics
NPI:1508914672
Name:WILLIAMS, JEAN ESTHER (MSW)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:ESTHER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:JEAN
Other - Middle Name:MARIE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 CRAFTS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3479
Mailing Address - Country:US
Mailing Address - Phone:413-586-3383
Mailing Address - Fax:
Practice Address - Street 1:6 CRAFTS AVE
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3479
Practice Address - Country:US
Practice Address - Phone:413-586-3383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1015364101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1843515Medicaid
MAPO4471Medicare ID - Type Unspecified