MEDICARE: MR. CARY GLENN 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	101YM0800X	Mental Health Counselor	18012	CA
2	1041C0700X	Clinical Social Worker	LCSW27815	CA

General Provider Information

NPI Number	:	1750438081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARY GLENN WILLIAMS LCSW

Provider Business Mailing Address
First Line	:	4468 E CESAR CHAVEZ BLVD BLDG 340
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93702-3605
Country	:	US
Telephone Number	:	559-600-6780
Fax Number	:

Provider Business Practice Location Address
First Line	:	4468 E CESAR CHAVEZ BLVD
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93702-3605
Country	:	US
Telephone Number	:	559-600-6780
Fax Number	:

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

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	03/25/2025

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