Individual provider Active NPI

Carla E Williams

  • Clinical Social Worker
  • Fayetteville, AR
National Provider Identifier
1033515341
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1585-C Issued in AR
Practice address
905 W Eden Cir
Fayetteville, AR 72701-6910
Phone
(479) 409-6167
Fax
(479) 587-8703
NPI assigned
Nov 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1585-C AR Primary

Addresses

Primary practice location

905 W Eden Cir
Fayetteville, AR 72701-6910

Mailing address

905 W Eden Cir
Fayetteville, AR 72701-6910
Phone (479) 409-6167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20150609000465 AR Practitioner - Clinical Social Worker 5597086017 Practice locations: Fayetteville, AR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

230 W Ctr
Fayetteville, AR 72701-5934

230 W Ctr St
Fayetteville, AR 72701-5934
Phone (479) 409-7753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1585-CARMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1033515341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 W EDEN CIR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727016910",
            "telephone_number": "479-409-6167",
            "fax_number": "479-587-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 W EDEN CIR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727016910",
            "telephone_number": "479-409-6167",
            "fax_number": "479-587-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CARLA",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-13",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1585-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.