Active NPI
Andra Williams, LPC
- Professional Counselor
- Traverse City, MI
National Provider Identifier
1396155149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401014142
- Practice address
- 954 Business Park Dr
Suite 2
Traverse City, MI 49686-8763 - Phone
- (231) 360-7785
- Fax
- (231) 642-5525
- NPI assigned
- May 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401014142 | MI | Primary |
Addresses
Primary practice location
954 Business Park Dr
Suite 2
Traverse City, MI 49686-8763
Mailing address
PO Box 517
Kingsley, MI 49649
Phone (231) 360-7785
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6401014142 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487548800000",
"number": "1396155149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 517",
"city": "KINGSLEY",
"state": "MI",
"postal_code": "49649",
"telephone_number": "231-360-7785",
"fax_number": "231-642-5525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "954 BUSINESS PARK DR",
"address_2": "SUITE 2",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496868763",
"telephone_number": "231-360-7785",
"fax_number": "231-642-5525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "ANDRA",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-02",
"last_updated": "2017-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401014142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.