Lylburn Clinton Williams

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

63759 Issued in TX

Practice address

702 San Pedro Ave
None
San Antonio, TX 78212-4610

Phone

(210) 563-4938

Fax

(210) 299-2413

NPI assigned

Feb 9, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Clint Williams Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Service Association of San Antonio, Inc.

  • Professional Counselor
  • San Antonio, TX
  • NPI 1528115011
  NPD (past)

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1255637112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SAN PEDRO AVE",
            "address_2": "NONE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124610",
            "telephone_number": "210-299-2400",
            "fax_number": "210-299-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 SAN PEDRO AVE",
            "address_2": "NONE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124610",
            "telephone_number": "210-563-4938",
            "fax_number": "210-299-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LYLBURN",
        "middle_name": "CLINTON",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-09",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "63759",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "63759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLINT",
            "last_name": "WILLIAMS",
            "prefix": "MR.",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Letha Williams
• Liandra Marie Williams, R.N.
• Lisa Williams, LPC
• Lisa Elaine Williams
• Lisa Marie Williams
• Malinda Williams, LPC
• Malissa Williams
• Mallory Williams
• Margaret Williams
• Maria Josefina Williams, CNA

• Mental Health Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.