Healthcare Provider Details

I. General information

NPI: 1043496623
Provider Name (Legal Business Name): CHAD ROBERT WILLIAMS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W HILL BLVD
CHARLESTON AFB SC
29404-4704
US

IV. Provider business mailing address

204 W HILL BLVD
CHARLESTON AFB SC
29404-4704
US

V. Phone/Fax

Practice location:
  • Phone: 843-963-6852
  • Fax:
Mailing address:
  • Phone: 843-963-6852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number8945
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC006809
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: