Jacquelynn Jae Williams

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2102890 Issued in OH

Practice address

4159 N Holland Sylvania Rd Ste 205
Toledo, OH 43623-4801

Phone

(419) 318-5286

NPI assigned

Jun 30, 2014

Sex

Female

Sole proprietor

No

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

Enrolled in OH

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

Specialty

Clinical Social Worker

Education

University of Toledo College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Behavioral Care of Ohio IncGroup PAC ID 7719325083, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacquelynn.williams.1@28621.direct.athenahealth.com

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.

• Optum Behavioral Care of Ohio, Inc

  • Counseling Psychologist
  • Columbus, OH
  • NPI 1285400978
  Medicare reassignment Care Compare group NPD
• Optum Behavioral Care of Ohio, Inc

  • Counseling Psychologist
  • Circleville, OH
  • NPI 1578325759
  NPD
• Optum Behavioral Care of Ohio, Inc.

  • Clinical Social Worker
  • Maryland Heights, MO
  • NPI 1528945623
  NPD
• Optum Behavioral Care of Ohio, Inc

  • Counseling Psychologist
  • Perrysburg, OH
  • NPI 1144082322
  NPD (past)

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1346655206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4159 N HOLLAND SYLVANIA RD STE 205",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234801",
            "telephone_number": "419-318-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4159 N HOLLAND SYLVANIA RD STE 205",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234801",
            "telephone_number": "419-318-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACQUELYNN",
        "middle_name": "JAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2102890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garland Williams Jr.
• Gloria A Williams, CMS
• Gloria Ann Williams
• Heather Williams, CAREGIVER
• Isaiah Williams
• Jaime Williams
• Jamella Williams, NP
• James Williams
• James Andrew Williams, DO
• Janaeaisha Syierra Williams, LSW

• Clinical Social Worker in Toledo, OH
• Providers in Toledo, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.