Healthcare Provider Details

I. General information

NPI: 1902216567
Provider Name (Legal Business Name): PATRICK AARON WILLIAMS LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 123
CORUNNA MI
48817-0123
US

IV. Provider business mailing address

211 N SHIAWASSEE ST STE A
CORUNNA MI
48817-1444
US

V. Phone/Fax

Practice location:
  • Phone: 810-422-9406
  • Fax: 810-410-4678
Mailing address:
  • Phone: 989-928-3566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801100004
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: