Mark A Williams, CADC III/LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

548 SW 13TH St
Bend, OR 97702-3184

Phone

(541) 388-8459

NPI assigned

Nov 2, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OR

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

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rimrock Trails Treatment ServicesGroup PAC ID 5799107629, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Rimrock Trails Treatment Services

  • Children's Substance Abuse Rehabilitation Facility
  • Prineville, OR
  • NPI 1194873406
  Medicare reassignment Care Compare group NPD
• The Redmond Family Medicine Center

  • Family Medicine Physician
  • Redmond, OR
  • NPI 1639256258
  NPD

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1598065807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 NW 9TH ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541482",
            "telephone_number": "541-447-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 SW 13TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023184",
            "telephone_number": "541-388-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "CADC III/LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-02",
        "last_updated": "2022-12-06",
        "certification_date": "2020-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "11-06-113",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500738403",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500738399",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON LPC LISC.",
            "identifier": "C7120",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris Daniel Williams, DMD
• Hannah Murie Fugle Williams, DPT
• Indiana Ray Williams
• Josh Williams
• Marc Vincent Williams, M.D.
• Matthew Williams, LMT IASI
• Melissa Marie Williams
• Nancy Ann Williams, R.N.
• Stephanie Williams, MSW,LCSW
• Kristin M Williamson, MS, CCC-SLP

• Mental Health Counselor in Bend, OR
• Providers in Bend, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.