Active NPI
Ingrid Stella Williams, LPCC
- Mental Health Counselor
- Clovis, NM
National Provider Identifier
1245330273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0091601
- Practice address
- 414 Mitchell St
Clovis, NM 88101-7354 - Phone
- (505) 762-9000
- Fax
- (505) 762-9009
- NPI assigned
- Sep 22, 2006
- Last updated
- Mar 17, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0091601 | NM | Primary |
Addresses
Primary practice location
414 Mitchell St
Clovis, NM 88101-7354
Mailing address
1100 W. 21St Street
Clovis, NM 88101
Phone (575) 769-2345
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2610551 | Medicaid | NM |
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 |
|---|---|---|---|
| 0091601 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426550400000",
"number": "1245330273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 W. 21ST STREET",
"city": "CLOVIS",
"state": "NM",
"postal_code": "88101",
"telephone_number": "575-769-2345",
"fax_number": "575-769-9013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 MITCHELL ST",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881017354",
"telephone_number": "505-762-9000",
"fax_number": "505-762-9009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "INGRID",
"middle_name": "STELLA",
"name_prefix": "Ms.",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-22",
"last_updated": "2015-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0091601",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2610551",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clovis, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.