Provider Demographics
NPI:1265813224
Name:WILLIAMS, WAYNE COLBY (LCSW)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:COLBY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MAIN ST STE 1306D
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-3516
Mailing Address - Country:US
Mailing Address - Phone:207-216-2637
Mailing Address - Fax:207-510-8054
Practice Address - Street 1:314 ALFRED ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-3102
Practice Address - Country:US
Practice Address - Phone:207-216-2637
Practice Address - Fax:207-510-8054
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC167121041C0700X
MEME15464104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker