Provider Demographics
NPI:1558912832
Name:MCWILLIAMS, BONNIE (LCAS, MAC, LAC)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:LCAS, MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 TIMBERWOOD RDG
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-5572
Mailing Address - Country:US
Mailing Address - Phone:910-322-8455
Mailing Address - Fax:
Practice Address - Street 1:712 TIMBERWOOD RDG
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-5572
Practice Address - Country:US
Practice Address - Phone:910-322-8455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24226101YA0400X
SC712101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)