Healthcare Provider Details

I. General information

NPI: 1255483244
Provider Name (Legal Business Name): ROGER CHARLES WILLIAMS MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2414 BULL ST
COLUMBIA SC
29201-1906
US

IV. Provider business mailing address

250 DEWEY AVE
SPARTANBURG SC
29303-3009
US

V. Phone/Fax

Practice location:
  • Phone: 803-898-8301
  • Fax: 803-898-8347
Mailing address:
  • Phone: 864-585-0366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number4487
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: