Individual provider Active NPI

Brandi Williamson I

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1083090906
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
12250 Sumter Square Dr W
Jacksonville, FL 32218-6125
Phone
(904) 358-1211
Fax
(904) 358-1551
NPI assigned
Aug 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

12250 Sumter Square Dr W
Jacksonville, FL 32218-6125

Mailing address

12250 Sumter Square Dr W
Jacksonville, FL 32218-6125
Phone (904) 358-1211

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brandi V. Williamson Mental Health Past Accepting new patients

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": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1083090906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12250 SUMTER SQUARE DR W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186125",
            "telephone_number": "904-358-1211",
            "fax_number": "904-358-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12250 SUMTER SQUARE DR W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186125",
            "telephone_number": "904-358-1211",
            "fax_number": "904-358-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "BRANDI",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.