| Carol Burnett Williams | |
|
814 W 21st Ave Covington LA 70433-7405 | |
| (985) 520-2920 | |
| (866) 465-0075 |
| Full Name | Carol Burnett Williams |
|---|---|
| Speciality | Counselor |
| Location | 814 W 21st Ave, Covington, Louisiana |
| Authorized Official Name and Position | Carol Burnett Williams (OWNER) |
| Authorized Official Contact | 9855202920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carol Burnett Williams 814 W 21st Ave Covington LA 70433-7405 Ph: (985) 520-2920 | Carol Burnett Williams 814 W 21st Ave Covington LA 70433-7405 Ph: (985) 520-2920 |
| NPI Number | 1306347869 |
|---|---|
| Provider Enumeration Date | 02/21/2018 |
| Last Update Date | 06/30/2023 |
| Certification Date | 06/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306347869 | NPI | - | NPPES |
| 1275833725 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 5610 (Louisiana) | Primary |
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