Orlinda Williams, LADAC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Supai, AZ

NPI 1235545302 · NPPES record last updated Jul 9, 2014

Key facts

NPI
1235545302
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
4004 (NM)
Practice address
1 Main Street
Supai, AZ 86435-0129
Phone
(928) 448-2641
Fax
(928) 448-2312
NPI assigned
Jul 9, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4004NMMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 4004 NM Yes

Addresses

Primary practice location

1 Main Street
Supai, AZ 86435-0129

Mailing address

PO Box 4391
Gallup, NM 87305-4391
Phone (928) 514-4715

Other providers in Supai, AZ

All providers in Supai, AZ · Addiction (Substance Use Disorder) Counselor in Arizona

Sources for this page

Verify at the official NPI Registry.