Petula Williams, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH23623 Issued in FL

Practice address

1239 E Main St
Bartow, FL 33830-5058

Phone

(863) 519-0575

NPI assigned

May 28, 2015

Sex

Female

Sole proprietor

No

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Cotler Healthcare & Development Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wellington, FL
  • NPI 1225075047
  Medicare reassignment NPD
• Peace River Center for Personal Development Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bartow, FL
  • NPI 1821097767
  Medicare reassignment NPD
• Peace River Center for Personal Development Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lakeland, FL
  • NPI 1538802939
  NPD

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1770962383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338311559",
            "telephone_number": "863-519-0575",
            "fax_number": "863-582-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 E MAIN ST",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338305058",
            "telephone_number": "863-519-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PETULA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH23623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122153000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa F Whittaker, CASEMANAGER
• Laura Joan Wiggins, LMHC
• Heather Leann Wilkerson, LM, CPM
• Latasha Williams
• Marlene Williams
• Richard Williams
• Rory Williams, MD
• Shawn Williams, CASEMANAGER
• Aimee Wilson, LMHC
• Netrena Wilson

• Mental Health Counselor in Bartow, FL
• Providers in Bartow, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.