Siddeeqah A Williams

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

17100000X Issued in MA

Practice address

100 Willow St
Lynn, MA 01901-1139

Phone

(781) 691-7060

Fax

(781) 691-7064

NPI assigned

Mar 21, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lynn Shelter Association

  • Case Management Agency
  • Lynn, MA
  • NPI 1619425196
  NPD (past)

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1699206862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILLOW ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011139",
            "telephone_number": "781-691-7060",
            "fax_number": "781-691-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILLOW ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011139",
            "telephone_number": "781-691-7060",
            "fax_number": "781-691-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SIDDEEQAH",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MA",
            "license": "17100000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASE MANAGER /CARE COORDINATOR",
            "identifier": "171M00000X",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa A Wiley
• Mary Josephine Wilkins, R.N.
• Willett & Associates
• Clotyl Williams, M.D
• Seyrel Williams, L.I.C.S.W.
• Willow Pharmacy
• Willow Street Medical Lab LLC
• Gretchen Willwerth, LICSW
• Mark Edward Wilner, DDS
• Claire Mary Wilson, M.S.W.

• Case Manager/Care Coordinator in Lynn, MA
• Providers in Lynn, MA by specialty
• Case Manager/Care Coordinator in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.