MEDICARE: RACHELLE 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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1508122060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHELLE WILLIAMS

Provider Business Mailing Address
First Line	:	181 JOLIET ST SW APT 102
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20032-1816
Country	:	US
Telephone Number	:	202-318-0179
Fax Number	:

Provider Business Practice Location Address
First Line	:	4660 MARTIN LUTHER KING JR AVE SW STE A2
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20032-4933
Country	:	US
Telephone Number	:	202-318-0179
Fax Number	:

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

Provider Enumeration Date	:	04/09/2012
Last Update Date	:	05/26/2026

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