Provider Demographics
NPI:1548402936
Name:WILLIAMS, EDWARD (LCPC, LCADC)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LCPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1259
Mailing Address - Country:US
Mailing Address - Phone:443-386-9080
Mailing Address - Fax:
Practice Address - Street 1:3218 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1259
Practice Address - Country:US
Practice Address - Phone:443-386-9080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5988101YM0800X
MDLCA1757101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)