Provider Demographics
NPI:1366781015
Name:WILLIAMS, DEMETRIUS DIJON (LMHC)
Entity type:Individual
Prefix:MR
First Name:DEMETRIUS
Middle Name:DIJON
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7402 N. 56TH ST,
Mailing Address - Street 2:BUILDING 100, SUITE 102
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617
Mailing Address - Country:US
Mailing Address - Phone:813-963-1016
Mailing Address - Fax:813-988-4005
Practice Address - Street 1:2810 W SAINT ISABEL ST STE 201B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6375
Practice Address - Country:US
Practice Address - Phone:813-421-9940
Practice Address - Fax:813-422-7827
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC 1100207101YP2500X
FLMH-15863101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional