Healthcare Provider Details

I. General information

NPI: 1568124287
Provider Name (Legal Business Name): CHRISTINE M. WILLIAMS, PHD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2021
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152R MAIN ST
WENHAM MA
01984-1422
US

IV. Provider business mailing address

3 WEBSTER ST APT 6
SALEM MA
01970-3879
US

V. Phone/Fax

Practice location:
  • Phone: 978-594-7780
  • Fax:
Mailing address:
  • Phone: 978-594-7780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. CHRISTINE M WILLIAMS
Title or Position: OWNER/PSYCHOLOGIST
Credential: PHD
Phone: 978-594-7780