Healthcare Provider Details

I. General information

NPI: 1780401810
Provider Name (Legal Business Name): D'LONDA MARIE WILLIAMS LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 S GRIFFIN ST STE J
ELIZABETH CITY NC
27909-4693
US

IV. Provider business mailing address

PO BOX 1251
ELIZABETH CITY NC
27906-1251
US

V. Phone/Fax

Practice location:
  • Phone: 252-331-0322
  • Fax:
Mailing address:
  • Phone: 770-733-8906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP021345
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-30757
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: