Individual provider Active NPI

Timothy Williams

  • Addiction (Substance Use Disorder) Counselor
  • Greenville, NC
National Provider Identifier
1134534274
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCAS20272 Issued in NC
Practice address
2602 Courtier Dr
Greenville, NC 27834-7818
Phone
(252) 752-0483
Fax
(252) 757-3172
NPI assigned
Jun 27, 2014
Last updated
Jun 27, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS20272 NC Primary

Addresses

Primary practice location

2602 Courtier Dr
Greenville, NC 27834-7818

Mailing address

4300 Sapphire CT Ste 110
Greenville, NC 27834-9079
Phone (252) 830-7561

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
LCAS20272NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1134534274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SAPPHIRE CT STE 110",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278349079",
            "telephone_number": "252-830-7561",
            "fax_number": "252-413-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 COURTIER DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347818",
            "telephone_number": "252-752-0483",
            "fax_number": "252-757-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS20272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; 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.