Individual provider Active NPI

Jodi Ann Williams, LPC MH

  • Mental Health Counselor
  • Brandon, SD
National Provider Identifier
1003956897
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2129 Issued in SD
Practice address
208 E Holly Blvd
Brandon, SD 57005-1171
Phone
(605) 201-3838
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X SD1003 SD
Mental Health Counselor 101YM0800X 2129 SD Primary

Addresses

Primary practice location

208 E Holly Blvd
Brandon, SD 57005-1171

Mailing address

920 S Patrician CT
Brandon, SD 57005-1735
Phone (605) 201-3838

Other practice location 1

12554 Bia Highway 711
Agency Village, SD 57262-7409
Phone (605) 419-1958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SD1003SDMDCounselor
2129SDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Therapeutic Services LLC Mental Health CurrentSince Feb 25, 2024 Accepting new patients

Locations

208 E Holly Blvd
Brandon, SD 57005
Phone (605) 201-3838

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1003956897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S PATRICIAN CT",
            "city": "BRANDON",
            "state": "SD",
            "postal_code": "570051735",
            "telephone_number": "605-201-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E HOLLY BLVD",
            "city": "BRANDON",
            "state": "SD",
            "postal_code": "570051171",
            "telephone_number": "605-201-3838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12554 Bia Highway 711",
            "address_purpose": "LOCATION",
            "city": "Agency Village",
            "state": "SD",
            "postal_code": "572627409",
            "country_code": "US",
            "telephone_number": "605-419-1958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JODI",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPC MH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SD",
            "license": "SD1003",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "2129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, SD

Sources for this page

Verify at the official NPI Registry.