Active NPI
Jacqueline L Williams
- Marriage & Family Therapist
- Lake Mary, FL
National Provider Identifier
1447493192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT 2384
- Practice address
- 3599 W Lake Mary Blvd
Suite B
Lake Mary, FL 32746-3417 - Phone
- (407) 956-5773
- NPI assigned
- Apr 10, 2009
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MT 2384 | FL | Primary |
Addresses
Primary practice location
3599 W Lake Mary Blvd
Suite B
Lake Mary, FL 32746-3417
Mailing address
3599 W Lake Mary Blvd
Suite B
Lake Mary, FL 32746-3417
Phone (407) 956-5773
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 |
|---|---|---|---|
| MT 2384 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395964800000",
"number": "1447493192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3599 W LAKE MARY BLVD",
"address_2": "SUITE B",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327463417",
"telephone_number": "407-956-5773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3599 W LAKE MARY BLVD",
"address_2": "SUITE B",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327463417",
"telephone_number": "407-956-5773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JACQUELINE",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-10",
"last_updated": "2014-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT 2384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.