Individual provider Active NPI

Nicole Townley Williams, MA, CCC-SLP

  • Speech-Language Pathologist
  • Saint Amant, LA
National Provider Identifier
1578889952
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5376 Issued in LA
Practice address
12018 Coueron Dr
Saint Amant, LA 70774-3565
Phone
(225) 937-8605
NPI assigned
Apr 11, 2010
Last updated
Nov 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5376 LA Primary

Addresses

Primary practice location

12018 Coueron Dr
Saint Amant, LA 70774-3565

Mailing address

2110 Pine St
Winnsboro, LA 71295-3236
Phone (225) 937-8605

Other practice location 1

2110 Pine St
Winnsboro, LA 71295-3236
Phone (225) 937-8605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131023001768 LA Practitioner - Qualified Speech Language Pathologist 9335374511 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisiana Voice and Swallow SolutionsGroup PAC ID 1153725783, 2 clinicians

Practice addresses (Care Compare)

12018 Coueron Dr
Saint Amant, LA 70774-3565
Phone (225) 269-9971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Rehabilitation Services, LLC CurrentSince Aug 1, 2013 Accepting new patients
Louisiana Voice and Swallow Solutions Speech-Language Pathologist CurrentSince Apr 2, 2021 Accepting new patients

Locations

2251 S Burnside Ave
Gonzales, LA 70737
Phone (225) 644-0290

2255 S Burnside Ave
Gonzales, LA 70737
Phone (225) 269-9971

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1270944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1578889952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 PINE ST",
            "city": "WINNSBORO",
            "state": "LA",
            "postal_code": "712953236",
            "telephone_number": "225-937-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12018 COUERON DR",
            "city": "SAINT AMANT",
            "state": "LA",
            "postal_code": "707743565",
            "telephone_number": "225-937-8605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2110 Pine St",
            "address_purpose": "LOCATION",
            "city": "Winnsboro",
            "state": "LA",
            "postal_code": "712953236",
            "country_code": "US",
            "telephone_number": "225-937-8605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "NICOLE",
        "middle_name": "TOWNLEY",
        "name_prefix": "Ms.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-11",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "5376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Amant, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.