Individual provider Active NPI

Mary Williams

  • Marriage & Family Therapist
  • Citrus Heights, CA
National Provider Identifier
1003417080
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
124891 Issued in CA
Practice address
8032 Twin Oaks Ave
Citrus Heights, CA 95610-0510
Phone
(916) 708-2951
NPI assigned
Nov 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 124891 CA Primary

Addresses

Primary practice location

8032 Twin Oaks Ave
Citrus Heights, CA 95610-0510

Mailing address

8032 Twin Oaks Ave
Citrus Heights, CA 95610-0510
Phone (916) 708-2951

Other practice location 1

4190 Douglas Blvd
Roseville, CA 95746-5905
Phone (855) 500-6463

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Roseville Direct

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
124891CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Levine M.D. Mindfulness Associates, P.C. Marriage & Family Therapist PastSince Feb 1, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1003417080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8032 TWIN OAKS AVE",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956100510",
            "telephone_number": "916-708-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8032 TWIN OAKS AVE",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956100510",
            "telephone_number": "916-708-2951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4190 Douglas Blvd",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "957465905",
            "country_code": "US",
            "telephone_number": "855-500-6463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2024-02-08",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "124891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Roseville",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4190 Douglas Blvd",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "957465905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.