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NPI Code Detail

MEDICARE: PAUL BRYAN WILLIAMS MC, NCC, LPC

MEDICARE: PAUL BRYAN WILLIAMS MC, NCC, 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1326176447
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL BRYAN WILLIAMS MC, NCC, LPC
Provider Business Mailing Address
First Line : 3526 NW 20TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73107-2818
Country : US
Telephone Number : 405-626-8551
Fax Number :
Provider Business Practice Location Address
First Line : 4300 N LINCOLN BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73105-5107
Country : US
Telephone Number : 405-424-7711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 02/08/2022

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