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General NPI Number Information
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NPI Number | 1518633288
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Entity Type | Individual
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Provider Name | CARL WILLIAMSON LMHC
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Gender | Male
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Dates
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Enumeration Date | 08/21/2021
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 139 FULTON ST RM 1008
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City | NEW YORK
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State | NY
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Zip | 10038-2544
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Country | US
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Telephone | 646-785-3270
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Fax |
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Provider Business Mailing Address
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Address Line | 504 GRAND ST APT G1
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City | NEW YORK
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State | NY
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Zip | 10002-0976
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Country | US
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Telephone | 646-785-3270
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 013419
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License Number State | NY
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