Colleen Williamson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPCC5984 Issued in CA

Practice address

3594 4TH Ave
San Diego, CA 92103-4940

Phone

(619) 296-1151

NPI assigned

Jan 10, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Crossroads Foundation

  • Substance Abuse Rehabilitation Facility
  • San Diego, CA
  • NPI 1881819621
  NPD (past)

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

{
    "created_epoch": "1452384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1396101143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N JOHNSON AVE",
            "address_2": "SUITE 101",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920201650",
            "telephone_number": "619-442-0277",
            "fax_number": "619-442-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3594 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034940",
            "telephone_number": "619-296-1151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 N Johnson Ave",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920201650",
            "country_code": "US",
            "telephone_number": "619-442-0277",
            "fax_number": "619-442-1101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "COLLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-10",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC5984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wytoshery Monea Williams, NURSE PRACTITIONER
• Yasmin Williams
• Yvonne Inez Williams
• Mary Renetta Williamson Coe, M.A.
• Andrew Trevor Williamson
• Darrell Wayne Williamson
• Elizabeth Williamson
• Jeffrey Lee Williamson, CMT
• Jennifer Williamson
• Joel Allen Williamson, APCC

• Professional Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.