Healthcare Provider Details

I. General information

NPI: 1043972912
Provider Name (Legal Business Name): WILLIAM'S RESTORATION OF HOPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2021
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 MERCANTILE LN STE 153
UPPER MARLBORO MD
20774-5334
US

IV. Provider business mailing address

1300 MERCANTILE LN STE 153
UPPER MARLBORO MD
20774-5334
US

V. Phone/Fax

Practice location:
  • Phone: 301-740-6034
  • Fax: 888-740-4113
Mailing address:
  • Phone: 301-740-6034
  • Fax: 888-740-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EDWARD WILLIAMS
Title or Position: CEO
Credential: LCADC-S, LCPC-S
Phone: 301-740-6034