Healthcare Provider Details

I. General information

NPI: 1306270517
Provider Name (Legal Business Name): CHEVAR MARTYSE WILLIAMS LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2013
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3751 JUNCTION BLVD STE D
RALEIGH NC
27603-5263
US

IV. Provider business mailing address

1423 INFINITY LN
RALEIGH NC
27610-6691
US

V. Phone/Fax

Practice location:
  • Phone: 919-492-5475
  • Fax:
Mailing address:
  • Phone: 919-649-8636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023924
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: