MEDICARE: LESLIE WILLIAMS

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1982237418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE WILLIAMS

Provider Business Mailing Address
First Line	:	PO BOX 211
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-0211
Country	:	US
Telephone Number	:	864-680-0164
Fax Number	:

Provider Business Practice Location Address
First Line	:	460 KING ST
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29403-6229
Country	:	US
Telephone Number	:	833-866-4900
Fax Number	:

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

Provider Enumeration Date	:	02/12/2020
Last Update Date	:	08/01/2020

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Directions to “ LESLIE WILLIAMS ” Practice Location

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