Carmon Nacole Williams

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111646 Issued in CA

Practice address

400 Corporate Pointe
300
Culver City, CA 90230-7615

Phone

(310) 882-8121

NPI assigned

Jan 4, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carmon.williams.1@28621.direct.athenahealth.com

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD
• Serene Pathways Family Counseling Inc

  • Marriage & Family Therapist
  • Chino, CA
  • NPI 1174913321
  NPD

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

{
    "created_epoch": "1388793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1124449426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23638 NEWHALL AVE",
            "address_2": "#6 424",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "91321",
            "telephone_number": "310-882-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CORPORATE POINTE",
            "address_2": "300",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902307615",
            "telephone_number": "310-882-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CARMON",
        "middle_name": "NACOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-04",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "111646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Sue Wiley, PH.D., CCC-SLP
• Kia Wilkins
• Diane Carel Willey
• Aviona Williams
• Belinda Williams
• Casey Williams
• Eboni S Williams, M.A., LPCC
• Jatoy Williams
• Jaynice Nichole Williams, MA, MFTI
• Kenneth E Williams

• Clinical Social Worker in Culver City, CA
• Providers in Culver City, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.