Basic Information
| Provider Information | |||||||||
| NPI: | 1902269004 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | BRANDON | ||||||||
| MiddleName: | JAMAAL ERNEST | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD. MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 BOULDER SPRINGS DR | ||||||||
| Address2: | APARTMENT #B3 | ||||||||
| City: | NORTH CHESTERFIELD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232255535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4045093281 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2727 ENTERPRISE PKWY STE 202 | ||||||||
| Address2: | |||||||||
| City: | HENRICO | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232946341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8042612090 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2016 | ||||||||
| LastUpdateDate: | 04/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 0810006196 | VA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.