Individual provider Active NPI

Tina Ann McWilliams, LICSW

  • Clinical Social Worker
  • Arley, AL
National Provider Identifier
1366547168
Registry record updated Mar 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1243C Issued in AL
Practice address
200 County Road 3941
Arley, AL 35541-2681
Phone
(166) 222-4431
NPI assigned
Sep 14, 2006
Last updated
Mar 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C5713 MS
Clinical Social Worker 1041C0700X 4470 TN
Clinical Social Worker 1041C0700X 1243C AL Primary

Addresses

Primary practice location

200 County Road 3941
Arley, AL 35541-2681

Mailing address

1045 Carter Dr
Tuscumbia, AL 35674-6917
Phone (662) 224-6210

Other identifiers 1

IdentifierTypeStateIssuer
1234COtherALALABAMA BOARD OF SOCIAL WORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20150729008343 AL Practitioner - Clinical Social Worker 0042523706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Remedy Behavioral Health LLCGroup PAC ID 3375958853, 46 clinicians

Practice addresses (Care Compare)

1609 Mockingbird CT
Suite B
Florence, AL 35630-7511
Phone (256) 320-7778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C5713MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Remedy Behavioral Health, LLC CurrentSince Aug 1, 2023 Accepting new patients
Shoals NP Homecare, LLC Current Accepting new patients

Locations

120 S Locust St
Florence, AL 35630
Phone (256) 320-7781

1609 Mockingbird Ct
Ste B
Florence, AL 35630
Phone (256) 320-7778

1001 S Jackson Hwy
Sheffield, AL 35660
Phone (256) 320-7778

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, 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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616803200000",
    "number": "1366547168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 CARTER DR",
            "city": "TUSCUMBIA",
            "state": "AL",
            "postal_code": "356746917",
            "telephone_number": "662-224-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 COUNTY ROAD 3941",
            "city": "ARLEY",
            "state": "AL",
            "postal_code": "355412681",
            "telephone_number": "166-222-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWILLIAMS",
        "first_name": "TINA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2021-03-27",
        "certification_date": "2021-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C5713",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "4470",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "1243C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA BOARD OF SOCIAL WORK",
            "identifier": "1234C",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arley, AL

Sources for this page

Verify at the official NPI Registry.