MEDICARE: MR. JAMES E WILLIAMS MSW

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	0904007185	VA
2	1041C0700X	Clinical Social Worker	R0274821	NY
3	1041C0700X	Clinical Social Worker	R027482-1	NY

General Provider Information

NPI Number	:	1912048190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES E WILLIAMS MSW

Provider Business Mailing Address
First Line	:	3419 VIRGINIA BEACH BLVD # 800
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-4419
Country	:	US
Telephone Number	:	757-714-1838
Fax Number	:	757-321-6269

Provider Business Practice Location Address
First Line	:	228 N LYNNHAVEN RD STE 110
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7514
Country	:	US
Telephone Number	:	757-340-6100
Fax Number	:	757-321-6269

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

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	10/14/2014

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