MEDICARE: CHARDAY D WILLIAMS MH22525

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC016436	GA
2	101YM0800X	Mental Health Counselor	MH22525	FL

General Provider Information

NPI Number	:	1144003096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARDAY D WILLIAMS MH22525

Provider Business Mailing Address
First Line	:	1400 NW 14TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-5426
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 NW 14TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-5426
Country	:	US
Telephone Number	:	305-625-6078
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2023
Last Update Date	:	03/20/2026

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