Provider Demographics
NPI:1689125437
Name:D WILLIAMS INC
Entity Type:Organization
Organization Name:D WILLIAMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEONNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:218-252-8821
Mailing Address - Street 1:522 BELTRAMI AVE NW
Mailing Address - Street 2:SUITE 116
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3001
Mailing Address - Country:US
Mailing Address - Phone:218-252-8821
Mailing Address - Fax:
Practice Address - Street 1:522 BELTRAMI AVE NW
Practice Address - Street 2:SUITE 116
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3001
Practice Address - Country:US
Practice Address - Phone:218-252-8821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN19439261QM0801X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)