Provider Demographics
NPI:1881917912
Name:BEVERLY A WILLIAMS, PHD
Entity type:Organization
Organization Name:BEVERLY A WILLIAMS, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:740-249-4152
Mailing Address - Street 1:3 W STIMSON AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2679
Mailing Address - Country:US
Mailing Address - Phone:740-249-4152
Mailing Address - Fax:740-249-4204
Practice Address - Street 1:2097 E STATE ST
Practice Address - Street 2:SUITE B
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2153
Practice Address - Country:US
Practice Address - Phone:740-249-4152
Practice Address - Fax:740-249-4204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH5451103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty