Provider Demographics
NPI:1780767129
Name:WILLIAMS, RICHARD W (RICHARD WILLIAMS PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:RICHARD WILLIAMS PHD
Other - Prefix:
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Mailing Address - Street 1:44 PIERREPONT AVE
Mailing Address - Street 2:FLAGG 153
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676-2200
Mailing Address - Country:US
Mailing Address - Phone:315-600-8020
Mailing Address - Fax:315-267-2677
Practice Address - Street 1:44 PIERREPONT AVE
Practice Address - Street 2:FLAGG 153
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676-2200
Practice Address - Country:US
Practice Address - Phone:315-600-8020
Practice Address - Fax:315-267-2677
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY010282103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical