Provider Demographics
NPI:1609192582
Name:WILLIAMS, MARY ANN (LCMHCS)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCMHCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CENTERVIEW DR. STE 36
Mailing Address - Street 2:
Mailing Address - City:GREENBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407
Mailing Address - Country:US
Mailing Address - Phone:336-254-7634
Mailing Address - Fax:336-609-6329
Practice Address - Street 1:2 CENTERVIEW DR STE 36
Practice Address - Street 2:
Practice Address - City:GREENBORO
Practice Address - State:NC
Practice Address - Zip Code:27407
Practice Address - Country:US
Practice Address - Phone:336-254-7634
Practice Address - Fax:336-609-6329
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1600101YA0400X
NC1600LCAS101YA0400X
NCA7828101YP2500X
NCLCMHC-SNCS7828101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)