Jill Williams, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC00565 Issued in MN

Practice address

110 6TH Ave S
Saint Cloud, MN 56301-5209

Phone

(320) 253-5930

Fax

(651) 925-0057

NPI assigned

Jul 10, 2013

Last updated

Oct 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jill Theisen Other name

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Attacure, LLC

  dba Creative Connections Counseling

  • Marriage & Family Therapist
  • Saint Cloud, MN
  • NPI 1104359157
  Medicare reassignment NPD

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1104267905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 25TH ST S",
            "address_2": "PO BOX 9859",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 6TH AVE S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563015209",
            "telephone_number": "320-253-5930",
            "fax_number": "651-925-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JILL",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC00565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "THEISEN",
            "credential": "LPCC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amy Jo Williams, RN
• Carol Jean Williams
• Daniel John Williams, D.C., MSN, RN, PHN
• Darius Daishaun Williams
• Geoffrey Alan Williams, RRT
• Travis Ryan Williams, MD
• Brian David Willie, LPN
• Nicole Willis
• Willow Tree Acupuncture LLC
• Travis Jared Wills

• Professional Counselor in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.