Active NPI
Thomas Mark Williams, P-LPC
- Counselor
- Grenada, MS
National Provider Identifier
1689551368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- P-1365
- Practice address
- 1300 Sunset Dr Ste M
Grenada, MS 38901-4082 - Phone
- (662) 809-7502
- Fax
- (662) 498-5261
- NPI assigned
- Aug 16, 2025
- Last updated
- Aug 16, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | P-1365 | MS | Primary |
Addresses
Primary practice location
1300 Sunset Dr Ste M
Grenada, MS 38901-4082
Mailing address
2445 Fairway St
Grenada, MS 38901-7912
Phone (662) 809-7502
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P-1365 | MS | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755302400000",
"number": "1689551368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2445 FAIRWAY ST",
"city": "GRENADA",
"state": "MS",
"postal_code": "389017912",
"telephone_number": "662-809-7502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 SUNSET DR STE M",
"city": "GRENADA",
"state": "MS",
"postal_code": "389014082",
"telephone_number": "662-809-7502",
"fax_number": "662-498-5261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "THOMAS",
"middle_name": "MARK",
"credential": "P-LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-08-16",
"last_updated": "2025-08-16",
"certification_date": "2025-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MS",
"license": "P-1365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grenada, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.