Basic Information
Provider Information
NPI: 1336161926
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMSON
FirstName: BRETT
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1754
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181051754
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2604 SCHOENERSVILLE RD
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180173518
CountryCode: US
TelephoneNumber: 6106918028
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/24/2006
LastUpdateDate: 10/18/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000XSW006458LPAY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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