Derrick Martin Williams, LMSW
Individual provider Active NPI Mental Health Counselor · Brooklyn, NY
NPI 1457774606 · NPPES record last updated Jan 23, 2014
Key facts
- NPI
- 1457774606
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 087863-1 (NY)
- Practice address
- 102 Pilling St
Brooklyn, NY 11207-1610 - Phone
- (718) 602-1000
- Fax
- (718) 602-1111
- NPI assigned
- Jan 23, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 087863-1 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Derrick M Williams M Div LCSW LLC | Current | Accepting new patients | |
| Coordinated Behavioral Care Ipa Inc | Past | Accepting new patients | |
| New York Psychotherapy and Counseling Center | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 087863-1 | NY | Yes |
Addresses
Primary practice location
102 Pilling St
Brooklyn, NY 11207-1610
Mailing address
102 Pilling St
Brooklyn, NY 11207-1610
Phone (718) 602-1000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 087863-1 | Other | NY | LICENSE NUMBER |
Other providers in Brooklyn, NY
- Daziah Williams
- Deasia Williams
- Deborah Williams
- Deirdre Shannon Williams
- Denise E. Williams
- Dolores V. Williams
- Donnette Alexia Williams
- Dorett Williams
- Drucilla L Williams
- Ebony Williams
All providers in Brooklyn, NY · Mental Health Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.