Healthcare Provider Details

I. General information

NPI: 1528979150
Provider Name (Legal Business Name): GARRY WILLIAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 SPRING BRANCH RD
KINSTON NC
28504-9039
US

IV. Provider business mailing address

2130 SPRING BRANCH RD
KINSTON NC
28504-9039
US

V. Phone/Fax

Practice location:
  • Phone: 252-268-7002
  • Fax:
Mailing address:
  • Phone: 252-268-7002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: