MEDICARE: AMENA RACHEL 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		AR

General Provider Information

NPI Number	:	1831955392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMENA RACHEL WILLIAMS

Provider Business Mailing Address
First Line	:	201 S 19TH ST STE D
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-1123
Country	:	US
Telephone Number	:	479-343-9393
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 S 19TH ST STE D
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-1123
Country	:	US
Telephone Number	:	479-343-9393
Fax Number	:

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

Provider Enumeration Date	:	02/22/2024
Last Update Date	:	06/02/2026

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