Provider Demographics
NPI:1174133912
Name:WILLIAMS CONSULTANT GROUP LLC
Entity type:Organization
Organization Name:WILLIAMS CONSULTANT GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERSONAL GERIATRIC ADVOCATE
Authorized Official - Prefix:
Authorized Official - First Name:GAZELLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:803-563-7844
Mailing Address - Street 1:215 CHAMPION ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-2206
Mailing Address - Country:US
Mailing Address - Phone:803-563-7844
Mailing Address - Fax:
Practice Address - Street 1:215 CHAMPION ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-2206
Practice Address - Country:US
Practice Address - Phone:803-563-7844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty