Individual provider Active NPI

Joshua Williams, MSW, LICSW

  • Clinical Social Worker
  • Foley, AL
National Provider Identifier
1043901895
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5344C Issued in AL
Practice address
209 W Jessamine Ave
Foley, AL 36535-2010
Phone
(205) 602-7365
NPI assigned
May 15, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 5097G AL
Clinical Social Worker 1041C0700X 5344C AL Primary

Addresses

Primary practice location

209 W Jessamine Ave
Foley, AL 36535-2010

Mailing address

6094 Cobblestone CT
Gulf Shores, AL 36542-2874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20230803001170 AL Practitioner - Clinical Social Worker 8426419649 Reassigns benefits to 1 organization
Practice locations: Foley, AL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Changing Tides Counseling Service LLCGroup PAC ID 0840640447, 2 clinicians

Practice addresses (Care Compare)

209 W Jessamine Ave
Foley, AL 36535-2010
Phone (205) 602-7365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5097GALMDSocial Worker
5344CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Changing Tides Counseling Service, LLC Clinical CurrentSince Nov 1, 2023 Accepting new patients

Locations

209 W Jessamine Ave
Foley, AL 36535
Phone (205) 533-2393

Organizations & group practices 1

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": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1043901895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6094 COBBLESTONE CT",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365422874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W JESSAMINE AVE",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352010",
            "telephone_number": "205-602-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOSHUA",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AL",
            "license": "5097G",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "5344C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

Verify at the official NPI Registry.