MEDICARE: DR. MARLON C WILLIAMS PHD, LPC, NCC, CPCS

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	012330	GA

General Provider Information

NPI Number	:	1609583368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARLON C WILLIAMS PHD, LPC, NCC, CPCS

Provider Business Mailing Address
First Line	:	4575 WEBB BRIDGE RD STE 3086
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30005-4256
Country	:	US
Telephone Number	:	404-969-5670
Fax Number	:

Provider Business Practice Location Address
First Line	:	956 BECKWITH ST SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30314-3123
Country	:	US
Telephone Number	:	404-969-5670
Fax Number	:	912-809-4288

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

Provider Enumeration Date	:	11/02/2022
Last Update Date	:	11/05/2022

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