Provider Demographics
NPI:1730191347
Name:MCWILLIAMS, GREGORY M (BS, LCDP)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:M
Last Name:MCWILLIAMS
Suffix:
Gender:M
Credentials:BS, LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 TEN ROD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4220
Mailing Address - Country:US
Mailing Address - Phone:401-294-6170
Mailing Address - Fax:401-295-5255
Practice Address - Street 1:580 TEN ROD RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4220
Practice Address - Country:US
Practice Address - Phone:401-294-6170
Practice Address - Fax:401-295-5255
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDP00251101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)