MEDICARE: NICHOLAS WILLIAMS

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	101YM0800X	Mental Health Counselor		OH
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1275236853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS WILLIAMS

Provider Business Mailing Address
First Line	:	733 W MARKET ST STE B5
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44303-1084
Country	:	US
Telephone Number	:	204-432-7659
Fax Number	:

Provider Business Practice Location Address
First Line	:	976 SNYDER ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44307-1860
Country	:	US
Telephone Number	:	330-601-7158
Fax Number	:

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

Provider Enumeration Date	:	03/23/2023
Last Update Date	:	12/18/2023

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Directions to “ NICHOLAS WILLIAMS ” Practice Location

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