Provider Demographics
NPI:1952759318
Name:SUMMERS, WILLIAM LUKE (PSYD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LUKE
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-9234
Mailing Address - Country:US
Mailing Address - Phone:254-231-1931
Mailing Address - Fax:
Practice Address - Street 1:133 JACKSON RD STE D
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-9234
Practice Address - Country:US
Practice Address - Phone:254-231-1931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health