Healthcare Provider Details
I. General information
NPI: 1942302815
Provider Name (Legal Business Name): PERCY LEE WILLIAMS JR. M.DIV., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
307 HAGUE ST
DETROIT MI
48202-2120
US
IV. Provider business mailing address
4646 JOHN R ST
DETROIT MI
48201-1916
US
V. Phone/Fax
- Phone: 313-263-6224
- Fax:
- Phone: 313-576-1000
- Fax: 313-576-1863
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP1600X |
| Taxonomy | Pastoral Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: