Provider Demographics
NPI:1679084586
Name:WILLIAMS OUTREACH & CONSULTING INC
Entity type:Organization
Organization Name:WILLIAMS OUTREACH & CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:TALLIE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MSW, LCSWA
Authorized Official - Phone:910-353-3119
Mailing Address - Street 1:99 VILLAGE DR STE 5
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7060
Mailing Address - Country:US
Mailing Address - Phone:910-353-3119
Mailing Address - Fax:
Practice Address - Street 1:99 VILLAGE DR STE 5
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7060
Practice Address - Country:US
Practice Address - Phone:910-353-3119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty