Healthcare Provider Details

I. General information

NPI: 1992611602
Provider Name (Legal Business Name): EMILY WILLIAMSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 BYTE CT STE G
FREDERICK MD
21702-8724
US

IV. Provider business mailing address

21 BYTE CT STE G
FREDERICK MD
21702-8724
US

V. Phone/Fax

Practice location:
  • Phone: 301-846-7872
  • Fax:
Mailing address:
  • Phone: 301-846-7872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberADT3934
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP18308
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: