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NPI Code Detail

MEDICARE: MRS. DIANNA NICOLE WILLIAMS LPC

MEDICARE: MRS. DIANNA NICOLE WILLIAMS LPC
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
1101YP2500XProfessional CounselorSC

General Provider Information

NPI Number : 1144731084
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANNA NICOLE WILLIAMS LPC
Provider Business Mailing Address
First Line : 439 CONGAREE RD STE 6
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-2868
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 439 CONGAREE RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-2867
Country : US
Telephone Number : 864-567-1163
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2017
Last Update Date : 05/15/2021

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