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NPI Code Detail

MEDICARE: MS. DENISE ANN WILLIAMS MEDICAL ASSISTANT

MEDICARE: MS. DENISE ANN WILLIAMS MEDICAL ASSISTANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1083191860
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DENISE ANN WILLIAMS MEDICAL ASSISTANT
Provider Business Mailing Address
First Line : 9220 MENTOR AVE
Second Line :
City : MENTOR
State : OH
Zip : 44060-6412
Country : US
Telephone Number : 440-354-9924
Fax Number : 440-205-1040
Provider Business Practice Location Address
First Line : 38876 MENTOR AVE
Second Line :
City : WILLOUGHBY
State : OH
Zip : 44094-7931
Country : US
Telephone Number : 440-578-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2018
Last Update Date : 08/14/2025

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