Individual provider Active NPI

Consuelo Williams, PMHNP-BC

  • Psychiatry Physician
  • Durham, NC
National Provider Identifier
1205511649
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5020093 Issued in NC
Practice address
23 Forest Creek Dr
Durham, NC 27713-6702
Phone
(191) 947-5903
NPI assigned
Jun 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5020093 NC Primary

Addresses

Primary practice location

23 Forest Creek Dr
Durham, NC 27713-6702

Mailing address

23 Forest Creek Dr
Durham, NC 27713-6702
Phone (191) 947-5903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260113001512 NC Practitioner - Nurse Practitioner 8729564430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Duke University School of Medicine, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11361 N 99TH Ave
Suite 402
Peoria, AZ 85345-5459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5020093NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Innovations, Inc CurrentSince Oct 3, 2025 Accepting new patients
Recovery Innovations, Inc CurrentSince Oct 3, 2025 Accepting new patients

Locations

2701 N 16th St
Ste 316
Phoenix, AZ 85006

309 Crutchfield St
Durham, NC 27704
Phone (919) 560-7305

1724 Roxie Ave
Fayetteville, NC 28304
Phone (910) 484-1212

107 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 250-1260

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": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1205511649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FOREST CREEK DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136702",
            "telephone_number": "191-947-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 FOREST CREEK DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136702",
            "telephone_number": "191-947-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CONSUELO",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-21",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "5020093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.