Provider Demographics
NPI:1417311101
Name:WILLIAMS, NAZARELL
Entity Type:Individual
Prefix:
First Name:NAZARELL
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 GRAND MEADOWS CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-2174
Mailing Address - Country:US
Mailing Address - Phone:804-497-6694
Mailing Address - Fax:804-918-9320
Practice Address - Street 1:6767 FOREST HILL AVE
Practice Address - Street 2:SUITE 216
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-1856
Practice Address - Country:US
Practice Address - Phone:804-497-6694
Practice Address - Fax:804-918-9320
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 171M00000X
VA0704006679101Y00000X, 101YM0800X
VA198003001172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No172V00000XOther Service ProvidersCommunity Health Worker