Jacqueline Lavinia Williams, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN-NP261557 Issued in GA

Practice address

3300 Old Milton Pkwy Ste 175
Alpharetta, GA 30005-2460

Phone

(470) 568-2010

Fax

(470) 880-5466

NPI assigned

Feb 17, 2017

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

Enrolled in GA, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brightside Medical of Michigan PCGroup PAC ID 9830562776, 90 clinicians

Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.jacquelinewilliams@124220.advancedmd-direct.com

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.

• Personal Recovery Network LLC

  • Psychiatry Physician
  • Stockbridge, GA
  • NPI 1881990869
  Medicare reassignment Care Compare group NPD
• Brightside Medical of Michigan PC

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1144800350

  GA

  Medicare reassignment Care Compare group NPD
• Emerginet Henry, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Atlanta, GA
  • NPI 1811946627
  Medicare reassignment NPD
• Emerginet, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Atlanta, GA
  • NPI 1164480869
  Medicare reassignment NPD
• Walker Lake Emergency Group, PC

  • Emergency Medicine Physician
  • Conyers, GA
  • NPI 1437629342
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, Psychiatric/Mental Health

  Medicare reassignment NPD
• Parkway Anesthesia Consultants, PC

  • Certified Registered Nurse Anesthetist
  • Villa Rica, GA
  • NPI 1194887455
  NPD (past)

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1477092856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 OLD MILTON PKWY STE 175",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300052460",
            "telephone_number": "470-568-2010",
            "fax_number": "470-880-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OLD MILTON PKWY STE 175",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300052460",
            "telephone_number": "470-568-2010",
            "fax_number": "470-880-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACQUELINE",
        "middle_name": "LAVINIA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-17",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN261557",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP261557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destinee Williams
• Douglas L Williams, MD
• Emily Williams, MPT
• Erin Williams
• Homeka Williams
• Janice Meagher Williams, LPC
• Jenna Williams, DC
• Kalyn Warren Williams, LMFT
• Karen Williams, LMFT
• Keith Williams, M.ED, CCC-SLP

• Psychiatric/Mental Health Nurse Practitioner in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; 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.