Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 20281 | NC |
Y | 101YP2500X | Professional Counselor | 10911 | NC |
NPI | 1003163213 |
---|---|
Provider Name | Keren Williams |
First Address | Albemarle, NC 28001-4932 |
Second Address | Lexington, NC 27292-7640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2012 |
Last Update Date | 01/03/2017 |