Provider Demographics
NPI:1659756633
Name:WILLIAMS CONSULTING SERVICES
Entity Type:Organization
Organization Name:WILLIAMS CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:314-898-5218
Mailing Address - Street 1:4101 E IOWA AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3725
Mailing Address - Country:US
Mailing Address - Phone:314-898-5218
Mailing Address - Fax:
Practice Address - Street 1:4101 E IOWA AVE APT 6
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3725
Practice Address - Country:US
Practice Address - Phone:314-898-5218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0010974251S00000X
MO000331251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1841343662OtherNPI