Individual provider Active NPI

Jonathan P Williams, LCMHC

  • Mental Health Counselor
  • Indian Trail, NC
National Provider Identifier
1700410024
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
15598 Issued in NC
Practice address
1006 Houndscroft Rd
Indian Trail, NC 28079-8814
Phone
(980) 263-9393
NPI assigned
Feb 25, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A15598 NC
Mental Health Counselor 101YM0800X 15598 NC Primary

Addresses

Primary practice location

1006 Houndscroft Rd
Indian Trail, NC 28079-8814

Mailing address

1006 Houndscroft Rd
Indian Trail, NC 28079-8814
Phone (704) 231-5597

Other practice location 1

3717 Latrobe Dr Ste 750
Charlotte, NC 28211-4826
Phone (980) 288-5486

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

LicenseStateTypeSpecialty
15598NCMDMental Health Counselor
A15598NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ubuntu Holistic Counseling & Consulting PLLC Mental Health CurrentSince Jul 17, 2022 Accepting new patients

Locations

1811 Sardis Rd N
Ste 207
Charlotte, NC 28270
Phone (704) 776-5584

Organizations & group practices 1

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": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1700410024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 HOUNDSCROFT RD",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280798814",
            "telephone_number": "704-231-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 HOUNDSCROFT RD",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280798814",
            "telephone_number": "980-263-9393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3717 Latrobe Dr Ste 750",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114826",
            "country_code": "US",
            "telephone_number": "980-288-5486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JONATHAN",
        "middle_name": "P",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-25",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15598",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "15598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.