MEDICARE: ATO WILLIAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	1041C0700X	Clinical Social Worker
3	104100000X	Social Worker

General Provider Information

NPI Number	:	1609621507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATO WILLIAMS

Provider Business Mailing Address
First Line	:	10 AVONCROFT LN
Second Line	:
City	:	MIDDLETOWN
State	:	NY
Zip	:	10940-5078
Country	:	US
Telephone Number	:	347-206-5699
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 AVONCROFT LN
Second Line	:
City	:	MIDDLETOWN
State	:	NY
Zip	:	10940-5078
Country	:	US
Telephone Number	:	347-206-5699
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	ATO A WILLIAMS
Credential	:	LCSW, CASAC-MC
Telephone Number	:	347-206-5699

Provider Enumeration Date	:	04/23/2024
Last Update Date	:	04/23/2024

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Directions to “ATO WILLIAMS ” Practice Location

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