Individual provider Active NPI

Marlon C Williams, PHD, LPC, NCC, CPCS

  • Mental Health Counselor
  • Atlanta, GA
National Provider Identifier
1609583368
Registry record updated Nov 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
012330 Issued in GA
Practice address
956 Beckwith St SW
Atlanta, GA 30314-3123
Phone
(404) 969-5670
Fax
(912) 809-4288
NPI assigned
Nov 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 012330 GA Primary

Addresses

Primary practice location

956 Beckwith St SW
Atlanta, GA 30314-3123

Mailing address

4575 Webb Bridge Rd Ste 3086
Alpharetta, GA 30005-4256
Phone (404) 969-5670

Other practice location 1

1780 Century Blvd NE Ste B
Atlanta, GA 30345-3399
Phone (404) 969-5670

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
012330GAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667606400000",
    "number": "1609583368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 WEBB BRIDGE RD STE 3086",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054256",
            "telephone_number": "404-969-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 BECKWITH ST SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303143123",
            "telephone_number": "404-969-5670",
            "fax_number": "912-809-4288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1780 Century Blvd NE Ste B",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303453399",
            "country_code": "US",
            "telephone_number": "404-969-5670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARLON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, NCC, CPCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-05",
        "certification_date": "2022-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "012330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2022; 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.