Active NPI
Jackson Neal Williams, LMHC
- Mental Health Counselor
- Bernalillo, NM
National Provider Identifier
1275801078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0151041
- Practice address
- 1000 Golden Yarrow TRL
Bernalillo, NM 87004-5780 - Phone
- (505) 227-4909
- NPI assigned
- Dec 7, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0151041 | NM | Primary |
Addresses
Primary practice location
1000 Golden Yarrow TRL
Bernalillo, NM 87004-5780
Mailing address
1000 Golden Yarrow TRL
Bernalillo, NM 87004-5780
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 |
|---|---|---|---|
| 0151041 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345852800000",
"number": "1275801078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 GOLDEN YARROW TRL",
"city": "BERNALILLO",
"state": "NM",
"postal_code": "870045780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 GOLDEN YARROW TRL",
"city": "BERNALILLO",
"state": "NM",
"postal_code": "870045780",
"telephone_number": "505-227-4909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JACKSON",
"middle_name": "NEAL",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-07",
"last_updated": "2012-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0151041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bernalillo, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.