Healthcare Provider Details

I. General information

NPI: 1376408484
Provider Name (Legal Business Name): HOLLY WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

3720 BENSON DR STE 101&102
RALEIGH NC
27609-7321
US

IV. Provider business mailing address

10419 STALLINGS RD
SPRING HOPE NC
27882-8720
US

V. Phone/Fax

Practice location:
  • Phone: 984-325-6889
  • Fax:
Mailing address:
  • Phone: 919-602-9281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA22376
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: