Active NPI
Carl Williams, PH.D.
- Addiction (Substance Use Disorder) Counselor
- Willimantic, CT
National Provider Identifier
1730403205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 000953
- Practice address
- 1491 Main St
Willimantic, CT 06226-1914 - Phone
- (860) 456-3215
- Fax
- (860) 423-3351
- NPI assigned
- Mar 26, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 103-022 | NJ | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 000953 | CT | Primary |
Addresses
Primary practice location
1491 Main St
Willimantic, CT 06226-1914
Mailing address
1491 Main St
Willimantic, CT 06226-1914
Phone (860) 456-3215
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37LC0013400 | Other | NJ | ADDICTIONS PROFESSIONAL LICENSE NUMBER |
| 103-022 | Other | NJ | PSYCHOLOGY INTERN PERMIT NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 103-022 | NJ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rolling Hills Recovery Center | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinic/Center
- Chester, NJ
- NPI 1194432138
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1730403205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1491 MAIN ST",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062261914",
"telephone_number": "860-456-3215",
"fax_number": "860-423-3351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1491 MAIN ST",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062261914",
"telephone_number": "860-456-3215",
"fax_number": "860-423-3351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "CARL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-26",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NJ",
"license": "103-022",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "000953",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADDICTIONS PROFESSIONAL LICENSE NUMBER",
"identifier": "37LC0013400",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGY INTERN PERMIT NUMBER",
"identifier": "103-022",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Willimantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.