MEDICARE: WILLIAMSON'S MENTAL HEALTH SERVICES LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1578944773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMSON'S MENTAL HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	3040 MITCHELLVILLE RD
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-1388
Country	:	US
Telephone Number	:	301-249-3934
Fax Number	:

Provider Business Practice Location Address
First Line	:	3040 MITCHELLVILLE RD
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-1388
Country	:	US
Telephone Number	:	301-249-3934
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MARCIA WILLIAMSON
Credential	:
Telephone Number	:	301-272-7674

Provider Enumeration Date	:	06/12/2015
Last Update Date	:	06/12/2015

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