Individual provider Active NPI

Jennifer L Williams, LMFT

  • Marriage & Family Therapist
  • Beaufort, SC
National Provider Identifier
1104157569
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT001286 Issued in GA
Practice address
69 Robert Smalls Pkwy Ste 2B
Beaufort, SC 29906
Phone
(843) 473-9216
Fax
(888) 333-7909
NPI assigned
Jan 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT001286 GA Primary

Addresses

Primary practice location

69 Robert Smalls Pkwy Ste 2B
Beaufort, SC 29906

Mailing address

69 Robert Smalls Pkwy Ste 2B
Beaufort, SC 29906-4273
Phone (843) 473-9216

Other practice location 1

2004 North St
Beaufort, SC 29902-4824
Phone (843) 473-9216

Other practice location 2

7 E Congress St Ste 1000C
Savannah, GA 31401-3357
Phone (912) 436-6320

Other practice location 3

2004 North St
Beaufort, SC 29902-4824
Phone (843) 473-9216

Other practice location 4

140 Lakes Blvd
Suite 215
Kingsland, GA 31548-6813
Phone (912) 510-9227

Other identifiers 2

IdentifierTypeStateIssuer
003149931AMedicaidGA
LT1076MedicaidSC

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
MFT001286GAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1104157569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 ROBERT SMALLS PKWY STE 2B",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299064273",
            "telephone_number": "843-473-9216",
            "fax_number": "888-333-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 ROBERT SMALLS PKWY STE 2B",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29906",
            "telephone_number": "843-473-9216",
            "fax_number": "888-333-7909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2004 North St",
            "address_purpose": "LOCATION",
            "city": "Beaufort",
            "state": "SC",
            "postal_code": "299024824",
            "country_code": "US",
            "telephone_number": "843-473-9216",
            "fax_number": "888-333-7909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 E Congress St Ste 1000C",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314013357",
            "country_code": "US",
            "telephone_number": "912-436-6320",
            "fax_number": "888-333-7909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2004 North St",
            "address_purpose": "LOCATION",
            "city": "Beaufort",
            "state": "SC",
            "postal_code": "299024824",
            "country_code": "US",
            "telephone_number": "843-473-9216",
            "fax_number": "888-333-7909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "140 Lakes Blvd",
            "address_2": "Suite 215",
            "address_purpose": "LOCATION",
            "city": "Kingsland",
            "state": "GA",
            "postal_code": "315486813",
            "country_code": "US",
            "telephone_number": "912-510-9227",
            "fax_number": "912-510-9228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003149931A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LT1076",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.