Healthcare Provider Details

I. General information

NPI: 1629015896
Provider Name (Legal Business Name): JAMIE WILLIAMS PSYD LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 04/26/2025
Certification Date: 04/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 LEDGE ST
PROVIDENCE RI
02904-1554
US

IV. Provider business mailing address

202 LEDGE ST
PROVIDENCE RI
02904-1554
US

V. Phone/Fax

Practice location:
  • Phone: 401-273-2386
  • Fax:
Mailing address:
  • Phone: 401-273-2386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMHC00192
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: