MEDICARE: MARY-ASHLEIGH WILLIAMS LCSW-A

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	P018081	NC

General Provider Information

NPI Number	:	1730893603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY-ASHLEIGH WILLIAMS LCSW-A

Provider Business Mailing Address
First Line	:	220 BETHUNE ST
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28305-4704
Country	:	US
Telephone Number	:	910-627-2847
Fax Number	:

Provider Business Practice Location Address
First Line	:	3077 N MAIN ST STE 201
Second Line	:
City	:	HOPE MILLS
State	:	NC
Zip	:	28348-1735
Country	:	US
Telephone Number	:	910-670-7340
Fax Number	:	866-990-0668

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

Provider Enumeration Date	:	01/05/2023
Last Update Date	:	01/05/2023

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