Provider Demographics
NPI:1740388503
Name:WILLIAMS, EDWARD LAMONT (MSW/LCSW)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:LAMONT
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 W MIDVALE AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4618
Mailing Address - Country:US
Mailing Address - Phone:610-619-9870
Mailing Address - Fax:610-619-9870
Practice Address - Street 1:710 S OLD MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5024
Practice Address - Country:US
Practice Address - Phone:610-619-9870
Practice Address - Fax:610-619-9879
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0148781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical