Jessi Lin Antle-Williams, LPC-23028
Individual provider Active NPI Professional Counselor · Tucson, AZ
NPI 1427729862 · NPPES record last updated Jun 14, 2024
Key facts
- NPI
- 1427729862
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC-23028 (AZ)
- Practice address
- 899 N Wilmot Rd Ste B
Tucson, AZ 85711-1712 - Phone
- (520) 290-1100
- NPI assigned
- Sep 24, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240719001176 | AZ | Practitioner - Mental Health Counselor | 8426594060 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-23028 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marana Health Center Inc | Current |
Accepting new patients | |
| Marana Health Center, Inc | Current |
Accepting new patients | |
| Marana Health Center, Inc | Past | Accepting new patients |
Locations
13395 N Marana Main St
Marana, AZ 85653
Phone (520) 616-6200
13395 N Marana Main St
Bldg B
Marana, AZ 85653
Phone (520) 682-1091
5224 W Dove Centre Rd
Marana, AZ 85658
Phone (520) 616-1445
2945 W Ina Rd
Ste 215
Tucson, AZ 85741
16701 N Oracle Rd
Ste 135
Tucson, AZ 85739
Phone (520) 682-1095
3690 S Park Ave
Ste 805
Tucson, AZ 85713
Phone (520) 616-1560
2325 N Wyatt Dr
Tucson, AZ 85712
Phone (520) 616-1510
899 N Wilmot Rd
Ste B
Tucson, AZ 85711
Phone (520) 290-1100
2945 W Ina Rd
Ste 215221
Tucson, AZ 85741
Phone (520) 616-1531
1707 W Saint Marys Rd
Ste 175
Tucson, AZ 85745
Phone (520) 616-6790
Interoperability endpoints
- jessi.antle-williams.1@32652.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-23028 | AZ | Yes |
Addresses
Primary practice location
899 N Wilmot Rd Ste B
Tucson, AZ 85711-1712
Mailing address
899 N Wilmot Rd Ste B
Tucson, AZ 85711-1712
Phone (520) 290-1100
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | janwilliams@mhchealthcare.org | Direct |
Other providers in Tucson, AZ
- Barbara A Anthony
- Erin Marie Anthony
- Michelle Robert Anthony
- Rosemarie Anthony
- Luis Arturo Antillon Jr.
- Kyle Antle
- Rein Anton
- Jessica Antonel
- Sandra K Antoniak
- Jodi Fay Antrobus
All providers in Tucson, AZ · Professional Counselor in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.