Williams, Nicholas Antonio

Williams, Nicholas Antonio is an sole proprietor health care provider with primary practice located at 12890 Harbor Dr , Woodbridge VA 22192-2921. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Williams, Nicholas Antonio can be contacted via phone (571) 316-1020.

Contact Information

Primary practice address
12890 Harbor Dr Woodbridge VA 22192-2921
Phone: (571) 316-1020
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 0701005312 Virginia
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0701005312 Virginia
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701005312 Virginia

Profile Details

NPI number 1720338627
LBN Legal business name Williams, Nicholas Antonio
Credentials NCC, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 18th, 2012
Last updated Dec 14th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720338627 NPPES
Virginia MEDICAID 2013135052

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