Active NPI
Clarence Williams, LCSW
- Clinical Social Worker
- Monroe, LA
National Provider Identifier
1194090183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12681
- Practice address
- 2404 Ferrand St Ste 23
Monroe, LA 71201-3233 - Phone
- (318) 323-0463
- NPI assigned
- Mar 9, 2012
- Last updated
- Jul 23, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1415 | LA | |
| Clinical Social Worker | 1041C0700X | 12681 | LA | Primary |
Addresses
Primary practice location
2404 Ferrand St Ste 23
Monroe, LA 71201-3233
Mailing address
PO Box 812
West Monroe, LA 71294-0812
Phone (954) 857-1105
Other practice location 1
611 E Union St
Minden, LA 71055-4731
Phone (318) 533-4239
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12681 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
| Immanuels Healing Center | Past | Accepting new patients |
Interoperability endpoints
- clarencewilliams@tdh.allscriptsdirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Monroe, LA
- NPI 1043472608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1194090183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 812",
"city": "WEST MONROE",
"state": "LA",
"postal_code": "712940812",
"telephone_number": "954-857-1105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2404 FERRAND ST STE 23",
"city": "MONROE",
"state": "LA",
"postal_code": "712013233",
"telephone_number": "318-323-0463"
}
],
"practiceLocations": [
{
"address_1": "611 E Union St",
"address_purpose": "LOCATION",
"city": "Minden",
"state": "LA",
"postal_code": "710554731",
"country_code": "US",
"telephone_number": "318-533-4239",
"fax_number": "318-274-3254",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "CLARENCE",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-09",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "LA",
"license": "1415",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "12681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.