MEDICARE: ANGELA MICHELLE WILLIAMS LLPC

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	101YP2500X	Professional Counselor
2	101Y00000X	Counselor	6401223626	MI

General Provider Information

NPI Number	:	1467181602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA MICHELLE WILLIAMS LLPC

Provider Business Mailing Address
First Line	:	9204 WESTLAKE CIR
Second Line	:
City	:	VAN BUREN TWP
State	:	MI
Zip	:	48111-6125
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9204 WESTLAKE CIR
Second Line	:
City	:	VAN BUREN TWP
State	:	MI
Zip	:	48111-6125
Country	:	US
Telephone Number	:	734-956-0333
Fax Number	:

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

Provider Enumeration Date	:	06/05/2022
Last Update Date	:	06/13/2024

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