Individual provider Active NPI

Eugenia Rosetta Williams, LCAS-A

  • Addiction (Substance Use Disorder) Counselor
  • Concord, NC
National Provider Identifier
1538407390
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCAS-20959 Issued in NC
Practice address
300 Copperfield Blvd NE
Concord, NC 28025-2428
Phone
(704) 782-3131
Fax
(704) 782-3133
NPI assigned
Jan 29, 2013
Last updated
Jan 10, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-20959 NC Primary

Addresses

Primary practice location

300 Copperfield Blvd NE
Concord, NC 28025-2428

Mailing address

300 Copperfield Blvd NE
Concord, NC 28025-2428
Phone (704) 782-3131

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

LicenseStateTypeSpecialty
LCAS-20959NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1538407390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 COPPERFIELD BLVD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252428",
            "telephone_number": "704-782-3131",
            "fax_number": "704-782-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COPPERFIELD BLVD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252428",
            "telephone_number": "704-782-3131",
            "fax_number": "704-782-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "EUGENIA",
        "middle_name": "ROSETTA",
        "credential": "LCAS-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-29",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-20959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.