Provider Demographics
NPI:1952820086
Name:WILLIAMS, MERCEDES MERRITT (DBH, MPH, IPEC, LMSW)
Entity Type:Individual
Prefix:DR
First Name:MERCEDES
Middle Name:MERRITT
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DBH, MPH, IPEC, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3182 BERTHAS OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-8458
Mailing Address - Country:US
Mailing Address - Phone:678-310-9707
Mailing Address - Fax:
Practice Address - Street 1:3182 BERTHAS OVERLOOK
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-8458
Practice Address - Country:US
Practice Address - Phone:678-310-9707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40044103K00000X
IN28315103TP2701X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy