Individual provider Active NPI

Amy R Williams, LCSW

  • Clinical Social Worker
  • Paragould, AR
National Provider Identifier
1164964656
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6212-C Issued in AR
Practice address
1101 Morgan Street
Suite 8
Paragould, AR 72450-2848
Phone
(870) 335-9483
Fax
(870) 335-9487
NPI assigned
Nov 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6212-M AR
Clinical Social Worker 1041C0700X 6212-C AR Primary
Social Worker 104100000X 6212-M

Addresses

Primary practice location

1101 Morgan Street
Suite 8
Paragould, AR 72450-2848

Mailing address

1815 Pleasant Grove Road
Jonesboro, AR 72405-7870
Phone (870) 933-6886

Other identifiers 1

IdentifierTypeStateIssuer
227352795MedicaidAR

Other names 1

  • Amy Renee Williams Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20231121002741 AR Practitioner - Clinical Social Worker 5799133260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Families, Inc of ArkansasGroup PAC ID 9335133669, 44 clinicians

Practice addresses (Care Compare)

118 Pleasant Grove Rd
Jonesboro, AR 72405-7870
Phone (870) 206-9428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6212-MARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Families, Inc of Arkansas CurrentSince Aug 19, 2023 Accepting new patients
Families, Inc. of Arkansas PastSince Aug 8, 2021 Accepting new patients

Locations

1815 Pleasant Grove Rd
Jonesboro, AR 72405
Phone (870) 833-6886

1425 W Main St
Walnut Ridge, AR 72476
Phone (870) 886-5303

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1164964656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE ROAD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724057870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MORGAN STREET",
            "address_2": "SUITE 8",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724502848",
            "telephone_number": "870-335-9483",
            "fax_number": "870-335-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AMY",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-15",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6212-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6212-C",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": "6212-M",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227352795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "WILLIAMS",
            "middle_name": "RENEE",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.