Provider Demographics
NPI:1902233828
Name:WILLIAMS, CHATARA MONET (PHD, MASTERS)
Entity Type:Individual
Prefix:DR
First Name:CHATARA
Middle Name:MONET
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD, MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 WESTERN BLVD # 1076
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6651
Mailing Address - Country:US
Mailing Address - Phone:910-629-2722
Mailing Address - Fax:
Practice Address - Street 1:507 SHADYSIDE CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-3196
Practice Address - Country:US
Practice Address - Phone:910-629-2722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-09
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1902233828OtherNPI