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NPI Code Detail

MEDICARE: BETTY B WILLIAMS LCSW

MEDICARE: BETTY B WILLIAMS LCSW
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 Counselor003981GA

General Provider Information

NPI Number : 1235233479
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETTY B WILLIAMS LCSW
Provider Business Mailing Address
First Line : 1873 S CARISBROOK PL
Second Line :
City : AUSTELL
State : GA
Zip : 30168-5147
Country : US
Telephone Number : 404-762-4042
Fax Number :
Provider Business Practice Location Address
First Line : 1636 CONNALLY DR
Second Line :
City : EAST POINT
State : GA
Zip : 30344-2558
Country : US
Telephone Number : 404-762-4042
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2006
Last Update Date : 07/08/2007

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