Basic Information
| Provider Information | |||||||||
| NPI: | 1043459530 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | ALVIN | ||||||||
| MiddleName: | EDWARD | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 SHARPLESS BLVD | ||||||||
| Address2: | |||||||||
| City: | WESTAMPTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080605650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094244516 | ||||||||
| FaxNumber: | 6098772090 | ||||||||
| Practice Location | |||||||||
| Address1: | 3801 LAKE BOONE TRL | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276072934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198658706 | ||||||||
| FaxNumber: | 9198658707 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2009 | ||||||||
| LastUpdateDate: | 02/06/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 7262 | NC | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.