Healthcare Provider Details

I. General information

NPI: 1740197201
Provider Name (Legal Business Name): CHRISTOPHER JORDAN WILLIAMS M.S. LBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 OLD POND RD STE 501
BRIDGEVILLE PA
15017-1273
US

IV. Provider business mailing address

600 OLD POND RD STE 501
BRIDGEVILLE PA
15017-1273
US

V. Phone/Fax

Practice location:
  • Phone: 833-867-8371
  • Fax:
Mailing address:
  • Phone: 833-867-8371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH008715
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: