Healthcare Provider Details
I. General information
NPI: 1750050803
Provider Name (Legal Business Name): WILLIAMS CONSULTING, CREATING OPPORTUNITIES FOR ADVANCEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2021
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1123 S UNIVERSITY AVE SUITE 255
LITTLE ROCK AR
72204
US
IV. Provider business mailing address
13109 FAULKNER LAKE RD
NORTH LITTLE ROCK AR
72117-5358
US
V. Phone/Fax
- Phone: 501-590-2488
- Fax: 501-325-9640
- Phone: 501-590-2488
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NAKIA
DENIESE
WILLIAMS
Title or Position: CEO/OWNER
Credential: LCSW
Phone: 501-613-7559