MEDICARE: DR. ERIC ANTOINE WILLIAMS LPCS, LMFT, BCC

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	106H00000X	Marriage & Family Therapist	1295	NC
2	101YP2500X	Professional Counselor	S6948	NC

General Provider Information

NPI Number	:	1396924502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC ANTOINE WILLIAMS LPCS, LMFT, BCC

Provider Business Mailing Address
First Line	:	PO BOX 27620
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-5043
Country	:	US
Telephone Number	:	910-364-9709
Fax Number	:	877-604-9199

Provider Business Practice Location Address
First Line	:	5135 MORGANTON RD STE 201
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-1525
Country	:	US
Telephone Number	:	910-364-9709
Fax Number	:	877-604-9199

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

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	10/11/2018

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