MEDICARE: MELISSA A WILLIAMS LPC,CSI,CSAC

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	1637	NC
2	101YM0800X	Mental Health Counselor	2769	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	:	1881755452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA A WILLIAMS LPC,CSI,CSAC

Provider Business Mailing Address
First Line	:	1558 UNION RD STE A
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-2215
Country	:	US
Telephone Number	:	704-852-3874
Fax Number	:	704-852-7060

Provider Business Practice Location Address
First Line	:	1558 UNION RD STE A
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-2215
Country	:	US
Telephone Number	:	704-852-3874
Fax Number	:	704-852-7060

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	06/26/2017

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