Individual provider Active NPI

Dennis Lee Williams Jr., LMFT

  • Mental Health Counselor
  • Fullerton, CA
National Provider Identifier
1043715840
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2800 Madison Ave
Fullerton, CA 92831-2210
Phone
(714) 234-0906
NPI assigned
Mar 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2800 Madison Ave
Fullerton, CA 92831-2210

Mailing address

2601 E Chapman Ave Ste 111
Fullerton, CA 92831-3737
Phone (714) 234-0906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250129002102 CA Practitioner - Marriage and Family Therapist 1456895895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mending Hearts Center Inc. Mental Health CurrentSince Dec 23, 2024 Accepting new patients
Dennis Williams MFT CurrentSince Dec 23, 2024 Accepting new patients

Locations

440 E Commonwealth Ave
Ste 205
Fullerton, CA 92832
Phone (714) 234-0906

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1043715840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 E CHAPMAN AVE STE 111",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313737",
            "telephone_number": "714-234-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MADISON AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928312210",
            "telephone_number": "714-234-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DENNIS",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.