MEDICARE: MELISSA WILLIAMSON MSW

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	101YM0800X	Mental Health Counselor	LC303309	DC

General Provider Information

NPI Number	:	1609016435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA WILLIAMSON MSW

Provider Business Mailing Address
First Line	:	64 NEW YORK AVE NE
Second Line	:	4TH FLOOR
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3320
Country	:	US
Telephone Number	:	202-673-7013
Fax Number	:	202-673-7502

Provider Business Practice Location Address
First Line	:	64 NEW YORK AVE NE
Second Line	:	4TH FLOOR
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3320
Country	:	US
Telephone Number	:	202-673-7013
Fax Number	:	202-673-7502

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

Provider Enumeration Date	:	03/06/2009
Last Update Date	:	03/06/2009

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