Healthcare Provider Details

I. General information

NPI: 1164234316
Provider Name (Legal Business Name): MRS. TUESDAY WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 BEDFORD PL
BALTIMORE MD
21218-1001
US

IV. Provider business mailing address

4410 BEDFORD PL
BALTIMORE MD
21218-1001
US

V. Phone/Fax

Practice location:
  • Phone: 313-300-8880
  • Fax: 410-500-4509
Mailing address:
  • Phone: 313-300-8880
  • Fax: 410-500-4509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberW14935308
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberW14935308
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberW14935308
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberW14935308
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: