Active NPI
Calandra Williams, LCDCIII
- Addiction (Substance Use Disorder) Counselor
- Cleveland, OH
National Provider Identifier
1508396102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 131187
- Practice address
- 4115 Bridge Ave
Cleveland, OH 44113-3304 - Phone
- (216) 631-5800
- Fax
- (216) 631-4595
- NPI assigned
- Jun 15, 2017
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 131187 | OH | Primary |
Addresses
Primary practice location
4115 Bridge Ave
Cleveland, OH 44113-3304
Mailing address
4115 Bridge Ave
Cleveland, OH 44113-3304
Phone (216) 631-5800
Other practice location 1
2115 Westpark Drive
Lorain, OH 44052
Phone (440) 989-4987
Other practice location 2
2115 Westpark Drive
Lorain, OH 44052
Phone (440) 989-4987
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 131187 | Other | OH | LICENSE |
| LCDCIII.131187 | Other | OH | LICENSE |
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 |
|---|---|---|---|
| 131187 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1508396102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4115 BRIDGE AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441133304",
"telephone_number": "216-631-5800",
"fax_number": "216-631-4595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4115 BRIDGE AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441133304",
"telephone_number": "216-631-5800",
"fax_number": "216-631-4595"
}
],
"practiceLocations": [
{
"address_1": "2115 WESTPARK DRIVE",
"address_purpose": "LOCATION",
"city": "LORAIN",
"state": "OH",
"postal_code": "44052",
"country_code": "US",
"telephone_number": "440-989-4987",
"fax_number": "440-246-0189",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2115 WESTPARK DRIVE",
"address_purpose": "LOCATION",
"city": "LORAIN",
"state": "OH",
"postal_code": "44052",
"country_code": "US",
"telephone_number": "440-989-4987",
"fax_number": "440-246-0189",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "CALANDRA",
"credential": "LCDCIII",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "131187",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "131187",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "LCDCIII.131187",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.