MEDICARE: MS. PAMELA ELAINE WILLIAMS M.S.

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	5058S	NC
2	101YM0800X	Mental Health Counselor	5058S	NC
3	101YP2500X	Professional Counselor	5058S	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1422E	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1467570549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAMELA ELAINE WILLIAMS M.S.

Provider Business Mailing Address
First Line	:	12500 ANGEL FALLS ROAD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27614
Country	:	US
Telephone Number	:	919-449-7059
Fax Number	:

Provider Business Practice Location Address
First Line	:	943 W ANDREWS AVE # K1
Second Line	:
City	:	HENDERSON
State	:	NC
Zip	:	27536-2516
Country	:	US
Telephone Number	:	919-449-7059
Fax Number	:	866-960-8494

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	12/26/2019

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