Individual provider Active NPI

Courtney Williams, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1275074908
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024174666 Issued in VA
Practice address
1300 Diamond Springs Rd Ste 503
Virginia Beach, VA 23455-3645
Phone
(757) 656-1665
NPI assigned
Mar 14, 2017
Last updated
Mar 14, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024174666 VA Primary

Addresses

Primary practice location

1300 Diamond Springs Rd Ste 503
Virginia Beach, VA 23455-3645

Mailing address

1300 Diamond Springs Rd Ste 503
Virginia Beach, VA 23455-3645
Phone (757) 656-1665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20170919000008 VA Practitioner - Nurse Practitioner 6305110156 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beach Counseling Center LLCGroup PAC ID 5496172983, 7 clinicians

Practice addresses (Care Compare)

1064 Laskin Rd
Suite 14C
Virginia Beach, VA 23451-6337
Phone (757) 233-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024174666VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beach Counseling Center LLC CurrentSince Oct 3, 2023 Accepting new patients
Reboot Functional Health Care Corporation CurrentSince Jan 21, 2022 Accepting new patients
Beach Counseling, LLC CurrentSince Apr 5, 2021 Accepting new patients
Danielle Gange, NP-C Psychiatric/Mental Health PastSince Nov 30, 2015 Accepting new patients

Locations

1064 Laskin Rd
Ste 14C
Virginia Beach, VA 23451
Phone (757) 233-1500

2528 Las Brisas Dr
Virginia Beach, VA 23456
Phone (757) 301-6985

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1275074908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 DIAMOND SPRINGS RD STE 503",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234553645",
            "telephone_number": "757-656-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 DIAMOND SPRINGS RD STE 503",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234553645",
            "telephone_number": "757-656-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "COURTNEY",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024174666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.