Provider Demographics
NPI:1053665125
Name:WILLIAMS, TIMOTHY ALAN (MDIV, DMIN, MA, ACC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ALAN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MDIV, DMIN, MA, ACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1572 HIGHWAY 85 NORTH
Mailing Address - Street 2:STE 335-PMB 3031
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7729
Mailing Address - Country:US
Mailing Address - Phone:678-870-5515
Mailing Address - Fax:678-870-5515
Practice Address - Street 1:9605 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48204-2139
Practice Address - Country:US
Practice Address - Phone:678-870-5515
Practice Address - Fax:678-870-5515
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral