Corey M Williams
Individual provider Active NPI Mental Health Counselor · Rollingbay, WA
NPI 1831846971 · NPPES record last updated Apr 28, 2025
Key facts
- NPI
- 1831846971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LH61651444 (WA)
- Practice address
- 10355 NE Valley Rd Unit 4481
Rollingbay, WA 98061-0020 - Phone
- (360) 908-0053
- NPI assigned
- Mar 8, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH61651444 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alta Vista Integrated Life Services | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH61651444 | WA | Yes |
Addresses
Primary practice location
10355 NE Valley Rd Unit 4481
Rollingbay, WA 98061-0020
Mailing address
PO Box 4481
Rollingbay, WA 98061-0481
Phone (360) 908-0053
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.