Demonte Williams, PRSS,CHW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

CHW0000000323 Issued in AZ

Practice address

2655 W Guadalupe Rd Unit Suite7
Mesa, AZ 85202-7259

Phone

(314) 494-7603

NPI assigned

Nov 16, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Principles Living LLC

  • Mental Health Counselor
  • Wauwatosa, WI
  • NPI 1174473151
  NPD Authorized official
• Titan Conglomerate LLC

  • Community/Behavioral Health Agency
  • Avondale, AZ
  • NPI 1457199945
  NPD

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

{
    "created_epoch": "1731715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731715200000",
    "number": "1144045071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12309 W CAMBRIDGE AVE",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925575",
            "telephone_number": "251-477-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 W GUADALUPE RD UNIT SUITE7",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852027259",
            "telephone_number": "314-494-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DEMONTE",
        "credential": "PRSS,CHW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-16",
        "last_updated": "2024-11-16",
        "certification_date": "2024-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AZ",
            "license": "CHW0000000323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Keith Williams, MD
• Cody Williams, RBT
• Dara Lynn Williams, RN
• Dawn Lynn Williams, NURSE PRACTITIONER
• Deanne Williams, LPC
• Evelyn Williams, CLINICAL DIRECTOR
• J. Ladd Williams, D.D.S.
• Jacquelyn Williams, MS SLPCF COMMUNICATI
• Jalen Williams
• James Alton Williams, MD

• Community Health Worker in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Community Health Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2024; 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.