Mary Ann Williams, LCMHCS
Individual provider Active NPI Professional Counselor · Greenboro, NC
NPI 1609192582 · NPPES record last updated Jul 10, 2023
Key facts
- NPI
- 1609192582
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LCMHC-SNCS7828 (NC)
- Practice address
- 2 Centerview Dr Ste 36
Greenboro, NC 27407 - Phone
- (336) 254-7634
- Fax
- (336) 609-6329
- NPI assigned
- Apr 16, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241206000640 | NC | Practitioner - Mental Health Counselor | 7416483060 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1600LCAS | NC | MD | Addiction (Substance Use Disorder) Counselor |
| A7828 | NC | MD | Professional Counselor |
| LCMHC-SNCS7828 | NC | MD | Professional Counselor |
| 1600 | NC | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Professional | Current |
Accepting new patients |
| Issues of Life Professional Counseling Services | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689
2 Centerview Dr
Ste 36
Greensboro, NC 27407
Phone (336) 254-7634
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1600 | NC | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1600LCAS | NC | |
| Professional Counselor | 101YP2500X | A7828 | NC | |
| Professional Counselor | 101YP2500X | LCMHC-SNCS7828 | NC | Yes |
Addresses
Primary practice location
2 Centerview Dr Ste 36
Greenboro, NC 27407
Mailing address
2 Centerview Dr. Ste 36
Greenboro, NC 27407
Phone (336) 254-7634
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.