Provider Demographics
NPI:1619237112
Name:WILLIAMS, JAYSON ALAN (MS)
Entity Type:Individual
Prefix:MR
First Name:JAYSON
Middle Name:ALAN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:LEHIGH
Mailing Address - State:OK
Mailing Address - Zip Code:74556-0031
Mailing Address - Country:US
Mailing Address - Phone:580-509-9151
Mailing Address - Fax:
Practice Address - Street 1:6 E LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:COALGATE
Practice Address - State:OK
Practice Address - Zip Code:74538-2676
Practice Address - Country:US
Practice Address - Phone:580-927-3168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty