Individual provider Active NPI

Mary Ann Williams, LCMHCS

  • Professional Counselor
  • Greenboro, NC
National Provider Identifier
1609192582
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LCMHC-SNCS7828 Issued in NC
Practice address
2 Centerview Dr Ste 36
Greenboro, NC 27407
Phone
(336) 254-7634
Fax
(336) 609-6329
NPI assigned
Apr 16, 2010
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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 Primary

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

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20241206000640 NC Practitioner - Mental Health Counselor 7416483060 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1600LCASNCMDAddiction (Substance Use Disorder) Counselor
A7828NCMDProfessional Counselor
LCMHC-SNCS7828NCMDProfessional Counselor
1600NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Professional CurrentSince Oct 1, 2024 Accepting new patients
Issues of Life Professional Counseling Services Addiction (Substance Use Disorder) CurrentSince Feb 25, 2024 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

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": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1609192582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CENTERVIEW DR. STE 36",
            "city": "GREENBORO",
            "state": "NC",
            "postal_code": "27407",
            "telephone_number": "336-254-7634",
            "fax_number": "336-609-6329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CENTERVIEW DR STE 36",
            "city": "GREENBORO",
            "state": "NC",
            "postal_code": "27407",
            "telephone_number": "336-254-7634",
            "fax_number": "336-609-6329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCMHCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-16",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1600",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1600LCAS",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A7828",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "LCMHC-SNCS7828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.