Healthcare Provider Details

I. General information

NPI: 1821953233
Provider Name (Legal Business Name): MEIKAYLA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5641 POPLAR TENT RD STE 204
CONCORD NC
28027-7588
US

IV. Provider business mailing address

5641 POPLAR TENT RD STE 204
CONCORD NC
28027-7588
US

V. Phone/Fax

Practice location:
  • Phone: 704-317-5720
  • Fax: 704-664-1029
Mailing address:
  • Phone: 704-317-5720
  • Fax: 704-664-1029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA22343
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: