Provider Demographics
NPI:1548927122
Name:WILLIAMS, JAIME LYN (LAC)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:LYN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:HEISLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08324-0229
Mailing Address - Country:US
Mailing Address - Phone:856-305-1789
Mailing Address - Fax:
Practice Address - Street 1:33 HIGH ST
Practice Address - Street 2:
Practice Address - City:HEISLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08324
Practice Address - Country:US
Practice Address - Phone:856-305-1789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00516300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health