Individual provider Active NPI

Damanique Williams, LPC-S, LCDC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1033549696
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
69116 Issued in TX
Practice address
16607 Blanco Rd
Suite 701
San Antonio, TX 78232-1913
Phone
(210) 749-2868
NPI assigned
Nov 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11685 TX
Professional Counselor 101YP2500X 69116 TX Primary

Addresses

Primary practice location

16607 Blanco Rd
Suite 701
San Antonio, TX 78232-1913

Mailing address

1200 Iowa St
San Antonio, TX 78203-1816
Phone (210) 749-2868

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

State licenses

LicenseStateTypeSpecialty
11685TXMDGeneral Practice Dentistry
69116TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1033549696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 IOWA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782031816",
            "telephone_number": "210-749-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16607 BLANCO RD",
            "address_2": "SUITE 701",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321913",
            "telephone_number": "210-749-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DAMANIQUE",
        "credential": "LPC-S, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-19",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "11685",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "69116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.