Provider Demographics
NPI:1972007672
Name:WILLIAMS, ROMEL LARNARD
Entity Type:Individual
Prefix:
First Name:ROMEL
Middle Name:LARNARD
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11888 LONGRIDGE AVE APT 3085
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-3918
Mailing Address - Country:US
Mailing Address - Phone:225-288-7217
Mailing Address - Fax:
Practice Address - Street 1:3180 CONVENTION ST # B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3711
Practice Address - Country:US
Practice Address - Phone:225-831-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health