Connor Williams, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.018440 Issued in IL

Practice address

2711 N Lawndale Ave Unit 2
Chicago, IL 60647-1127

Phone

(773) 980-9138

NPI assigned

May 30, 2016

Last updated

Dec 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 1, 2016 through Dec 1, 2026

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fifth Star Collective, LLC

  dba Verdant Path Collective

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1104425552
  NPD Authorized official

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

{
    "created_epoch": "1464566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1336597418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 N LAWNDALE AVE UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471127",
            "telephone_number": "773-980-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 N LAWNDALE AVE UNIT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471127",
            "telephone_number": "773-980-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CONNOR",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-30",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christel Williams
• Christopher Patrick Williams, PH.D.
• Clarissa Lauren Williams
• Claude E Williams, D.C.
• Cody James Williams, MD
• Constance Y Williams, PHD
• Corinne Williams, PA-C
• Cory R Williams, NP
• Crystal Williams, MSW, LSW, LCSW
• Crystal Y. Williams, LCPC

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.