Freddie Lee Williams

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-032-468 Issued in NC

Practice address

3671 Guess Rd
Durham, NC 27705-6908

Phone

(919) 251-9821

Fax

(919) 471-3904

NPI assigned

Feb 21, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gate-Way Corporation

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Durham, NC
  • NPI 1235294737
  NPD (past) Authorized official
• Vision

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Durham, NC
  • NPI 1467692988

  Residential Treatment Facility, Emotionally Disturbed Children

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235174400000",
    "number": "1285874909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14281",
            "city": "RESEARCH TRIANGLE PARK",
            "state": "NC",
            "postal_code": "277094281",
            "telephone_number": "919-479-6917",
            "fax_number": "919-471-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3671 GUESS RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277056908",
            "telephone_number": "919-251-9821",
            "fax_number": "919-471-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "FREDDIE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-21",
        "last_updated": "2009-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-032-468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604362",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiney Lee'Shon Williams, LCSWA
• Eileen Gail Williams, LCSWA
• Elaina Williams, CPNP
• Faith Shelby Williams, NP
• Frances Carolyn Williams, PH.D.
• Gina Williams
• Helen Audrey Williams
• Hilda Lavette Williams, LCSW
• Jada Tierra Williams
• Jan Williams, LCSW

• Emotionally Disturbed Childrens' Residential Treatment Facility in Durham, NC
• Providers in Durham, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.