Individual provider Active NPI

Amelia Mae Williams, DT

  • Mental Health Counselor
  • New Albany, IN
National Provider Identifier
1174659932
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39000659A Issued in IN
Practice address
3317 Julian Dr
New Albany, IN 47150-9530
Phone
(812) 944-9984
Fax
(812) 944-9984
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X
Mental Health Counselor 101YM0800X 39000659A IN Primary
Professional Counselor 101YP2500X KY-0464 KY

Addresses

Primary practice location

3317 Julian Dr
New Albany, IN 47150-9530

Mailing address

3317 Julian Dr
New Albany, IN 47150-9530
Phone (812) 944-9984

Other identifiers 1

IdentifierTypeStateIssuer
200625290AOtherINDEVELOPMENTAL THERAPIST

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
39000659AINMDMental Health Counselor
KY-0464KYMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1174659932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 JULIAN DR",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471509530",
            "telephone_number": "812-944-9984",
            "fax_number": "812-944-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 JULIAN DR",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471509530",
            "telephone_number": "812-944-9984",
            "fax_number": "812-944-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AMELIA",
        "middle_name": "MAE",
        "credential": "DT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39000659A",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "KY-0464",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEVELOPMENTAL THERAPIST",
            "identifier": "200625290A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.