=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972447225
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NAKIYAH WILLIAMS CLC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2026
-----------------------------------------------------
Last Update Date | 04/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 E BROAD ST STE 130-1267
-----------------------------------------------------
City | BETHLEHEM
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18018-5913
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-272-5971
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 E BROAD ST STE 130-1267
-----------------------------------------------------
City | BETHLEHEM
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18018-5913
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-272-5971
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 339476
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------