MEDICARE: MRS. BRIDGET THERESA WILLIAMS MS

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	101YM0800X	Mental Health Counselor	2315	SD

General Provider Information

NPI Number	:	1669914115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRIDGET THERESA WILLIAMS MS

Provider Business Mailing Address
First Line	:	PO BOX 125
Second Line	:	14116 STURGIS ROAD
City	:	PIEDMONT
State	:	SD
Zip	:	57769-0125
Country	:	US
Telephone Number	:	605-441-2038
Fax Number	:

Provider Business Practice Location Address
First Line	:	3315 S VALLEY DR
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57703-5944
Country	:	US
Telephone Number	:	605-441-2038
Fax Number	:

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

Provider Enumeration Date	:	11/15/2016
Last Update Date	:	10/09/2025

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