Provider Demographics
NPI:1659839538
Name:WILLIAMS, JOSEPH M (LPC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 DEPTFORD RD
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-2409
Mailing Address - Country:US
Mailing Address - Phone:856-794-1011
Mailing Address - Fax:856-794-1239
Practice Address - Street 1:1405 N DELSEA DR
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-2291
Practice Address - Country:US
Practice Address - Phone:856-794-1011
Practice Address - Fax:856-794-1239
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-09
Last Update Date:2019-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00633100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional