Mary Katherine Williams, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1752C Issued in AR

Practice address

2233 N Green Acres Rd
Fayetteville, AR 72703-2833

Phone

(479) 466-9121

Fax

(479) 974-2002

NPI assigned

May 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AR

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

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ozark Guidance Center, Inc

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1659945194
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1376501593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4669 W TUMBLEWEED ST",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727047642",
            "telephone_number": "479-466-9121",
            "fax_number": "479-974-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 N GREEN ACRES RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032833",
            "telephone_number": "479-466-9121",
            "fax_number": "479-974-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1752C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "089.0134618TELE",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "1752C",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "61413647",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "5X496",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katera Williams
• Kevin Williams
• Kevin Alan Williams, LPC
• Kimberly Williams, LMSW
• Kristie Ladawn Williams, LAC
• Meredith L Williams
• Nathan G Williams
• Nathan L Williams, PH.D
• Scott Alan Williams
• Skyler Williams, DMD

• Clinical Social Worker in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.