Healthcare Provider Details

I. General information

NPI: 1104356674
Provider Name (Legal Business Name): AUBREY WILLIAMS MA, MSW, LCSWA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2634 CHAPEL HILL BLVD STE 216
DURHAM NC
27707-2877
US

IV. Provider business mailing address

2930 ETHAN POINTE DR APT 8309
BURLINGTON NC
27215-9535
US

V. Phone/Fax

Practice location:
  • Phone: 919-682-5777
  • Fax:
Mailing address:
  • Phone: 919-423-3920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP016205
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP011681
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: