Individual provider Active NPI

Joan Teresa Williams, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1336317510
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 7511 Issued in FL
Practice address
613 W Ashley St
Jacksonville, FL 32202-4747
Phone
(352) 316-0803
Fax
(904) 396-8759
NPI assigned
Feb 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 7511 FL Primary

Addresses

Primary practice location

613 W Ashley St
Jacksonville, FL 32202-4747

Mailing address

613 W Ashley St
Jacksonville, FL 32202-4747
Phone (352) 316-0803

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

LicenseStateTypeSpecialty
SW 7511FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1336317510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 W ASHLEY ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024747",
            "telephone_number": "352-316-0803",
            "fax_number": "904-396-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 W ASHLEY ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024747",
            "telephone_number": "352-316-0803",
            "fax_number": "904-396-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOAN",
        "middle_name": "TERESA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-11",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 7511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; 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.