Johanna Maria Paulien Williams, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.024632 Issued in IL

Practice address

1319 E Wantland Dr
Taylorville, IL 62568-9305

Phone

(217) 820-0307

NPI assigned

Aug 9, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Clinical

  Medicare reassignment NPD
• Psychology Specialists LTD

  dba LifeStance Health

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1023791852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 E WANTLAND DR",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625689305",
            "telephone_number": "217-820-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 E WANTLAND DR",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625689305",
            "telephone_number": "217-820-0307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3008 Happy Landing Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627116259",
            "country_code": "US",
            "telephone_number": "888-428-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOHANNA",
        "middle_name": "MARIA PAULIEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walmart Inc.
• Kimberly Denae Washburn, LCSW
• Barbara Westrick White
• Whole Family Wellness LLC
• Amber Dawn Williams, LCPC
• Morgan Kathleen Winans, APRN, CNP
• Andrew Powell Windmiller, LCPC
• Crystal Wingerter, DNP, APRN, FNP-C
• Megan A. Winters, NP
• Beth Ann Woodcock, OTA/L

• Clinical Social Worker in Taylorville, IL
• Providers in Taylorville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.