Individual provider Active NPI

Christy L Jordan-Williams

  • Professional Counselor
  • Laurens, SC
National Provider Identifier
1336730621
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8925 Issued in SC
Practice address
121 W Public SQ Ste B
Laurens, SC 29360-2972
Phone
(864) 507-9149
Fax
(864) 778-5592
NPI assigned
Jan 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8925 SC Primary

Addresses

Primary practice location

121 W Public SQ Ste B
Laurens, SC 29360-2972

Mailing address

PO Box 292
Greenwood, SC 29648-0292
Phone (864) 507-9149

Other practice location 1

1611 Woodlawn Rd
Greenwood, SC 29649-9419
Phone (864) 507-9149

Other identifiers 2

IdentifierTypeStateIssuer
PC2938MedicaidSC
SCV568R393OtherSCMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241203004601 SC Practitioner - Mental Health Counselor 6406382217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1611 Woodlawn Rd
Greenwood, SC 29649-9419
Phone (864) 214-5374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8925SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rise Therapy LLC Professional CurrentSince Oct 10, 2024 Accepting new patients
South Carolina Dept of Mental Health Accounting Office PastSince Jan 1, 2021 Accepting new patients

Locations

1611 Woodlawn Rd
Greenwood, SC 29649
Phone (864) 214-5374

121 W Public Sq
Ste B
Laurens, SC 29360
Phone (864) 214-5374

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1336730621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 292",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296480292",
            "telephone_number": "864-507-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W PUBLIC SQ STE B",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293602972",
            "telephone_number": "864-507-9149",
            "fax_number": "864-778-5592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 Woodlawn Rd",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296499419",
            "country_code": "US",
            "telephone_number": "864-507-9149",
            "fax_number": "864-778-5592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN-WILLIAMS",
        "first_name": "CHRISTY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "8925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC2938",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SCV568R393",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurens, SC

Sources for this page

Verify at the official NPI Registry.