Provider Demographics
NPI:1376958207
Name:WILLIAMS, MARK B (MSW)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:B
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 EASTOWNE DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-6224
Mailing Address - Country:US
Mailing Address - Phone:919-408-3212
Mailing Address - Fax:919-408-3306
Practice Address - Street 1:501 EASTOWNE DR
Practice Address - Street 2:SUITE 220
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-6224
Practice Address - Country:US
Practice Address - Phone:919-408-3212
Practice Address - Fax:919-408-3306
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0088621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical