Breeanne Williams, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

104132 Issued in CA

Practice address

3015 E Houston Dr
San Tan Valley, AZ 85143-1697

Phone

(714) 747-2347

NPI assigned

Jun 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Breeanne Chism Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Telemedicine Group PCGroup PAC ID 9830351824, 94 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: telemed2u.breeannewilliams@160918.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.

• Telehealth Specialty Medical Group

  • Emergency Medicine Physician
  • Roseville, CA
  • NPI 1326338237
  Medicare reassignment Care Compare group NPD
• Wings of the Future, NFP

  • Clinical Social Worker
  • Dallas, TX
  • NPI 1194481556

  CA

  Medicare reassignment NPD
• Tele-Medicine Services Ny, PLLC

  • Internal Medicine Physician
  • Roseville, CA
  • NPI 1609663780
  NPD (past)

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1508358334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 E HOUSTON DR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851431697",
            "telephone_number": "714-747-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 E HOUSTON DR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851431697",
            "telephone_number": "714-747-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BREEANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "84248",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "104132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREEANNE",
            "last_name": "CHISM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• CJ Werner
• Caitlin Whitaker, PT, DPT
• Brandi May White
• Ariel Mone'T Williams, SLPA
• Audra S Williams, CNM
• Kimberly L Wimbush, MS. MA. LAC.
• Monique Althea Wise
• Jenna Wofford
• Candace Wolters, LMSW
• Women of Excellence Healthcare, PLLC

• Clinical Social Worker in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.