MEDICARE: MR. CLINTON MCCRAY WILLIAMS LCMHCS

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	101YP2500X	Professional Counselor	4547	NC
2	101YM0800X	Mental Health Counselor	4547	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881732220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CLINTON MCCRAY WILLIAMS LCMHCS

Provider Business Mailing Address
First Line	:	PO BOX M
Second Line	:
City	:	GARYSBURG
State	:	NC
Zip	:	27831-0330
Country	:	US
Telephone Number	:	252-532-6570
Fax Number	:	252-537-4005

Provider Business Practice Location Address
First Line	:	100 ELM ST
Second Line	:
City	:	WELDON
State	:	NC
Zip	:	27890-1934
Country	:	US
Telephone Number	:	522-537-4005
Fax Number	:	252-537-0329

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

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	05/09/2023

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