MEDICARE: JACOBIA JOI 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	1041C0700X	Clinical Social Worker	C009535	NC

General Provider Information

NPI Number	:	1730671132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOBIA JOI WILLIAMS LCSW

Provider Business Mailing Address
First Line	:	2716 HIGHLAND PARK DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-0526
Country	:	US
Telephone Number	:	704-780-5997
Fax Number	:

Provider Business Practice Location Address
First Line	:	2716 HIGHLAND PARK DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-0526
Country	:	US
Telephone Number	:	704-780-5997
Fax Number	:

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

Provider Enumeration Date	:	05/31/2018
Last Update Date	:	03/10/2026

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