Provider Demographics
NPI:1679984975
Name:WILLIAMS, EDDIE DEMEATRICE III (LAMFT)
Entity type:Individual
Prefix:MR
First Name:EDDIE
Middle Name:DEMEATRICE
Last Name:WILLIAMS
Suffix:III
Gender:M
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WOODROW WILSON DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2587
Mailing Address - Country:US
Mailing Address - Phone:229-219-1811
Mailing Address - Fax:
Practice Address - Street 1:111 WOODROW WILSON DR
Practice Address - Street 2:SUITE B
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2587
Practice Address - Country:US
Practice Address - Phone:229-219-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMFT000303106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist