MEDICARE: PROMISE 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	101YA0400X	Addiction (Substance Use Disorder) Counselor		GA

General Provider Information

NPI Number	:	1275462434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROMISE WILLIAMS

Provider Business Mailing Address
First Line	:	2941 PEYTON DR
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31903-2635
Country	:	US
Telephone Number	:	706-530-6317
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 13TH ST
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-2248
Country	:	US
Telephone Number	:	170-688-7503
Fax Number	:

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

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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Directions to “ PROMISE WILLIAMS ” Practice Location

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