Provider Demographics
NPI:1831950922
Name:WILLIAMS, JASON OMAR
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:OMAR
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 1:2908 S DAKOTA AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2634
Mailing Address - Country:US
Mailing Address - Phone:202-642-4518
Mailing Address - Fax:
Practice Address - Street 1:1436 U ST NW STE 401
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-3988
Practice Address - Country:US
Practice Address - Phone:202-506-5486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical