Healthcare Provider Details

I. General information

NPI: 1962315937
Provider Name (Legal Business Name): GARRETT WILLIAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2433 MAIN AVE APT E5
NORTHPORT AL
35476-3696
US

IV. Provider business mailing address

2433 MAIN AVE APT E5
NORTHPORT AL
35476-3696
US

V. Phone/Fax

Practice location:
  • Phone: 205-534-5787
  • Fax:
Mailing address:
  • Phone: 205-534-5787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberALC06192
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: