MEDICARE: DANIELLE R WILLIAMS MA

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1417439183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE R WILLIAMS MA

Provider Business Mailing Address
First Line	:	PO BOX 47
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49204-0047
Country	:	US
Telephone Number	:	317-253-7387
Fax Number	:

Provider Business Practice Location Address
First Line	:	2437 SHELBY ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-4252
Country	:	US
Telephone Number	:	317-253-7387
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2018
Last Update Date	:	12/12/2024

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