Healthcare Provider Details

I. General information

NPI: 1790589505
Provider Name (Legal Business Name): NAOMI WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BIESECKER RD
LEXINGTON NC
27295-1501
US

IV. Provider business mailing address

253 ROCKFORD RD
KERNERSVILLE NC
27284-2340
US

V. Phone/Fax

Practice location:
  • Phone: 334-242-1546
  • Fax:
Mailing address:
  • Phone: 334-450-9928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number1286759
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: