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NPI Code Detail

MEDICARE: DOMINIQUE WILLIAMS

MEDICARE:   DOMINIQUE  WILLIAMS
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
1101YM0800XMental Health CounselorPC015857PA
2101YP2500XProfessional CounselorPC015857PA

General Provider Information

NPI Number : 1255913588
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOMINIQUE WILLIAMS
Provider Business Mailing Address
First Line : 101 PEMBROKE CT
Second Line :
City : GREENSBURG
State : PA
Zip : 15601-6404
Country : US
Telephone Number : 724-396-1510
Fax Number : 724-972-4627
Provider Business Practice Location Address
First Line : 7605 SALTSBURG RD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15239-1723
Country : US
Telephone Number : 724-396-1510
Fax Number : 724-972-4627
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2021
Last Update Date : 10/10/2023

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Directions to “ DOMINIQUE WILLIAMS ” Practice Location

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