MEDICARE: PAULA MARIE WILLIAMS LCSW

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	104100000X	Social Worker	093756-1	NY
2	1041C0700X	Clinical Social Worker	098780	NY
3	1041C0700X	Clinical Social Worker	0904018642	VA

General Provider Information

NPI Number	:	1649667924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA MARIE WILLIAMS LCSW

Provider Business Mailing Address
First Line	:	575 LYNNHAVEN PKWY STE 305
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7350
Country	:	US
Telephone Number	:	804-207-6737
Fax Number	:

Provider Business Practice Location Address
First Line	:	575 LYNNHAVEN PKWY STE 305
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7350
Country	:	US
Telephone Number	:	804-207-6737
Fax Number	:

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

Provider Enumeration Date	:	04/23/2015
Last Update Date	:	07/02/2025

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