Provider Demographics
NPI:1619018587
Name:WILLIAMS, MECHAL NOELL
Entity Type:Individual
Prefix:MISS
First Name:MECHAL
Middle Name:NOELL
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 1:4200 SUNSET FALLS RD
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-4312
Mailing Address - Country:US
Mailing Address - Phone:919-673-4419
Mailing Address - Fax:
Practice Address - Street 1:4200 SUNSET FALLS RD
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4312
Practice Address - Country:US
Practice Address - Phone:919-673-4419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11302101YM0800X
101YM0800X
NCA11302101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health