Individual provider Active NPI

Mark Williams, LPC

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1366827008
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
71741 Issued in TX
Practice address
1527 Hemphill St
Fort Worth, TX 76104-4706
Phone
(817) 569-5900
NPI assigned
Jul 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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 71741 TX Primary

Addresses

Primary practice location

1527 Hemphill St
Fort Worth, TX 76104-4706

Mailing address

3933 Woodlane Ave
Haltom City, TX 76117-3562
Phone (682) 554-7481

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
71741TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1366827008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3933 WOODLANE AVE",
            "city": "HALTOM CITY",
            "state": "TX",
            "postal_code": "761173562",
            "telephone_number": "682-554-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 HEMPHILL ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044706",
            "telephone_number": "817-569-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARK",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "71741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.