Individual provider Active NPI

Emily McClung Williams, LPC, LAC, AADC, MAC

  • Mental Health Counselor
  • Greenville, SC
National Provider Identifier
1063938637
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7780 Issued in SC
Practice address
3519 Pelham Rd Ste 105
Greenville, SC 29615-4182
Phone
(864) 664-2230
Fax
(864) 738-7106
NPI assigned
Aug 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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 188 SC
Mental Health Counselor 101YM0800X 7780 SC Primary

Addresses

Primary practice location

3519 Pelham Rd Ste 105
Greenville, SC 29615-4182

Mailing address

3519 Pelham Rd Ste 105
Greenville, SC 29615-4182
Phone (864) 664-2230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 28, 2024 through Oct 28, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
188SCMDAcupuncturist
7780SCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution of Self: Counseling and Consulting LLC Addiction (Substance Use Disorder) CurrentSince Mar 12, 2024 Accepting new patients

Locations

3519 Pelham Rd
Ste 105
Greenville, SC 29615
Phone (864) 664-2230

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1063938637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3519 PELHAM RD STE 105",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154182",
            "telephone_number": "864-664-2230",
            "fax_number": "864-738-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 PELHAM RD STE 105",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154182",
            "telephone_number": "864-664-2230",
            "fax_number": "864-738-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "EMILY",
        "middle_name": "MCCLUNG",
        "credential": "LPC, LAC, AADC, MAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "188",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "7780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.