Individual provider Active NPI

Beverly H Williams, LPC

  • Professional Counselor
  • Marietta, GA
National Provider Identifier
1013305218
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC007277 Issued in GA
Practice address
208 Station Club Dr SW
Marietta, GA 30060-7550
Phone
(404) 375-5682
NPI assigned
Dec 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC007277 GA Primary

Addresses

Primary practice location

208 Station Club Dr SW
Marietta, GA 30060-7550

Mailing address

PO Box 788
Mableton, GA 30126-0788
Phone (404) 375-5682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240228003273 GA Practitioner - Mental Health Counselor 4385089481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Rivers Community Service BoardGroup PAC ID 9032000245, 57 clinicians
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

1650 County Service Pkwy SW
Marietta, GA 30008-4010
Phone (770) 514-2422

2713 Charles Hardy Pkwy
Suite 223
Dallas, GA 30157-9470
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Rivers Community Service Board CurrentSince Jan 1, 2024 Accepting new patients
Highland Rivers CSB CurrentSince Jan 1, 2024 Accepting new patients

Locations

191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600

1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507

1650 County Services Pkwy SW
Marietta, GA 30008
Phone (770) 514-2300

Networks

  • FL HMO D-SNP
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • FL HMO C-SNP
  • AL HMO
  • AL HMO D-SNP
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • FL HMO
  • TN PPO

Organizations & group practices 3

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": "1419292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1013305218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301260788",
            "telephone_number": "404-375-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 STATION CLUB DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607550",
            "telephone_number": "404-375-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BEVERLY",
        "middle_name": "H",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-23",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.