Provider Demographics
NPI:1538382288
Name:WILLIAMS, JANICE E (PHD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 GRAND CONCOURSE APT 1ES
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-3017
Mailing Address - Country:US
Mailing Address - Phone:212-283-5444
Mailing Address - Fax:
Practice Address - Street 1:800 GRAND CONCOURSE APT 1ES
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-3017
Practice Address - Country:US
Practice Address - Phone:212-283-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010111-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY135524OtherVALUE OPTIONS PROVIDER
NY230921OtherCOMPSYCH PROVIDER NUMBER
NY0063459OtherGHI PROVIDER NUMBER
NY0063459OtherGHI PROVIDER NUMBER