Individual provider Active NPI

Michael Christopher Williamson, LMFT

  • Marriage & Family Therapist
  • Gray, GA
National Provider Identifier
1356947923
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT000666 Issued in GA
Practice address
183 W Clinton St
Gray, GA 31032-5301
Phone
(478) 227-4189
NPI assigned
Dec 9, 2020
Last updated
Jun 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT000666 GA Primary

Addresses

Primary practice location

183 W Clinton St
Gray, GA 31032-5301

Mailing address

109 Osigian Blvd Ste 400
Warner Robins, GA 31088-8925

Other practice location 1

109 Osigian Blvd Ste 400
Warner Robins, GA 31088-8925
Phone (478) 449-1475

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
AMFT000666GAMDMarriage & Family Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1356947923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 OSIGIAN BLVD STE 400",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 W CLINTON ST",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310325301",
            "telephone_number": "478-227-4189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Osigian Blvd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310888925",
            "country_code": "US",
            "telephone_number": "478-449-1475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-09",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "AMFT000666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gray, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.