Provider Demographics
NPI:1932574704
Name:WILLIAMS, JARED MICHEAL
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:MICHEAL
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 1:2200 VETERANS BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70062
Mailing Address - Country:US
Mailing Address - Phone:504-305-4704
Mailing Address - Fax:504-305-4709
Practice Address - Street 1:2200 VETERANS BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062
Practice Address - Country:US
Practice Address - Phone:504-305-4704
Practice Address - Fax:504-305-4709
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-04
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health