MEDICARE: STEPHEN ARNOLD 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	129423517	TN
2	261QA0600X	Adult Day Care Clinic/Center	129423517	TN
3	171400000X	Health & Wellness Coach	129423517	TN
4	101YM0800X	Mental Health Counselor	129423517	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HCBS04060	OTHER	TN	HCBS04060

General Provider Information

NPI Number	:	1619836210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN ARNOLD WILLIAMS

Provider Business Mailing Address
First Line	:	225 MONTEREY MILLS CV
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-4127
Country	:	US
Telephone Number	:	901-612-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	6089 APPLE TREE DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38115-8600
Country	:	US
Telephone Number	:	901-612-1400
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	05/28/2026

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