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NPI Code Detail

MEDICARE: MRS. NICOLE R WILLIAMS MS, LPC, ED.S

MEDICARE: MRS. NICOLE R WILLIAMS MS, LPC, ED.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
1101YM0800XMental Health CounselorC.1300625OH

General Provider Information

NPI Number : 1598444515
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NICOLE R WILLIAMS MS, LPC, ED.S
Provider Business Mailing Address
First Line : 411 IMANI CIR
Second Line :
City : TOLEDO
State : OH
Zip : 43604-8404
Country : US
Telephone Number : 419-654-7067
Fax Number :
Provider Business Practice Location Address
First Line : 2602 NEBRASKA AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43607-3241
Country : US
Telephone Number : 419-318-9121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2023
Last Update Date : 07/17/2023

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