Provider Demographics
NPI:1578217667
Name:DEYETTE, WILLIAM JOSEPH IV (BSW, CACII)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:DEYETTE
Suffix:IV
Gender:M
Credentials:BSW, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 COMMERCIAL CT STE A
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3671
Mailing Address - Country:US
Mailing Address - Phone:912-352-4357
Mailing Address - Fax:912-352-4357
Practice Address - Street 1:600 COMMERCIAL CT STE A
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3671
Practice Address - Country:US
Practice Address - Phone:912-352-4357
Practice Address - Fax:912-352-4395
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2011101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty