Active NPI
Chanel Dominique Williams, ASW
- Mental Health Counselor
- Long Beach, CA
National Provider Identifier
1013630318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 3939 Atlantic Ave Ste 103
Long Beach, CA 90807-3529 - Phone
- (562) 264-6001
- NPI assigned
- Sep 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
3939 Atlantic Ave Ste 103
Long Beach, CA 90807-3529
Mailing address
447 N El Molino Ave
Pasadena, CA 91101-1403
Phone (626) 577-8480
Other practice location 1
2116 Arlington Ave Ste 100
Los Angeles, CA 90018-1353
Phone (323) 334-9000
Other practice location 2
2116 Arlington Ave Ste 100
Los Angeles, CA 90018-1353
Phone (323) 334-9000
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687392000000",
"number": "1013630318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "447 N EL MOLINO AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911011403",
"telephone_number": "626-577-8480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3939 ATLANTIC AVE STE 103",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908073529",
"telephone_number": "562-264-6001"
}
],
"practiceLocations": [
{
"address_1": "2116 Arlington Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900181353",
"country_code": "US",
"telephone_number": "323-334-9000",
"fax_number": "323-334-4437",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2116 Arlington Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900181353",
"country_code": "US",
"telephone_number": "323-334-9000",
"fax_number": "323-334-4437",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "CHANEL",
"middle_name": "DOMINIQUE",
"name_prefix": "Ms.",
"credential": "ASW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-21",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.