Provider Demographics
NPI:1336401967
Name:WILLIAMS, BENJAMIN D (PHD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44095 PIPELINE PLZ STE 240
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7515
Mailing Address - Country:US
Mailing Address - Phone:703-723-2999
Mailing Address - Fax:703-723-4144
Practice Address - Street 1:44095 PIPELINE PLZ STE 240
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-7515
Practice Address - Country:US
Practice Address - Phone:703-723-2999
Practice Address - Fax:703-723-4144
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004972103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical