Healthcare Provider Details

I. General information

NPI: 1740468115
Provider Name (Legal Business Name): STEVEN JAMES WILLIAMS LPA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 QUIET MILL RD A6
RALEIGH NC
27612-4308
US

IV. Provider business mailing address

3209 QUIET MILL RD A6
RALEIGH NC
27612-4308
US

V. Phone/Fax

Practice location:
  • Phone: 919-685-7662
  • Fax:
Mailing address:
  • Phone: 919-685-7662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number2106
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2106
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number2106
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: