Individual provider Active NPI

Andrea Lynn Williams, MA

  • Professional Counselor
  • Eugene, OR
National Provider Identifier
1023453529
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C3643 Issued in OR
Practice address
2411 Martin Luther King Jr Blvd
Eugene, OR 97401-5824
Phone
(541) 682-3608
NPI assigned
May 10, 2013
Last updated
Aug 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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 C3643 OR Primary

Addresses

Primary practice location

2411 Martin Luther King Jr Blvd
Eugene, OR 97401-5824

Mailing address

930 Hammer St
Harrisburg, OR 97446-9590
Phone (541) 954-3072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240129003903 OR Practitioner - Mental Health Counselor 1850744509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sokyahealth Medical Group PCGroup PAC ID 9739575648, 68 clinicians

Practice addresses (Care Compare)

8555 SW Apple Way
Suite 320
Portland, OR 97225-1775
Phone (877) 840-6956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Sokyahealth Medical Group PC Mental Health CurrentSince Feb 1, 2024 Accepting new patients
Sean's Place, Incorporated PastSince Aug 28, 2022 Accepting new patients

Locations

700 NE Multnomah St
Ste 870
Portland, OR 97232
Phone (503) 238-5559

8555 SW Apple Way
Ste 320
Portland, OR 97225
Phone (503) 430-5762

Interoperability endpoints

  • Direct secure messaging: andrea.williams.p1@direct.sokya.nextgenshare.com
  • Direct secure messaging: andreawilliams@tdh.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1023453529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 HAMMER ST",
            "city": "HARRISBURG",
            "state": "OR",
            "postal_code": "974469590",
            "telephone_number": "541-954-3072",
            "fax_number": "541-995-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 MARTIN LUTHER KING JR BLVD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974015824",
            "telephone_number": "541-682-3608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-10",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.