Justin Williamson, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A19289 Issued in NC

Practice address

942 W 4TH St
Winston Salem, NC 27101-2582

Phone

(336) 355-8244

Fax

(336) 546-7630

NPI assigned

Dec 11, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1689441404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 WATERFORD VILLAGE DR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128586",
            "telephone_number": "601-590-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 W 4TH ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271012582",
            "telephone_number": "336-355-8244",
            "fax_number": "336-546-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A19289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfonza Hills Williamson Jr., DDS
• Edward Van Velsor Williamson, M.D.
• Emily Crawford Williamson, M.D.
• Jeff Douglas Williamson, MD
• John C Williamson, PHARMD
• Latoya S Williamson, NP
• Prerana Aghamkar Williamson, MD
• Thomas Clayton Williamson Jr., M.D.
• Anaiya Taneil Willie
• Phillip Mabon Williford, MD

• Mental Health Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.