Active NPI
Theodora Vaughn Williams, CDCI
- Addiction (Substance Use Disorder) Counselor
- Wrangell, AK
National Provider Identifier
1790947737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 2673
- Practice address
- 333 Church St
Wrangell, AK 99929 - Phone
- (907) 305-3055
- Fax
- (907) 874-2576
- NPI assigned
- Jul 1, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2673 | AK | Primary |
Addresses
Primary practice location
333 Church St
Wrangell, AK 99929
Mailing address
Box 1731
219 Greif St
Wrangell, AK 99929
Phone (907) 305-3055
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 |
|---|---|---|---|
| 2673 | AK | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1790947737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 1731",
"address_2": "219 GREIF ST",
"city": "WRANGELL",
"state": "AK",
"postal_code": "99929",
"telephone_number": "907-305-3055",
"fax_number": "907-874-2576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 CHURCH ST",
"city": "WRANGELL",
"state": "AK",
"postal_code": "99929",
"telephone_number": "907-305-3055",
"fax_number": "907-874-2576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "THEODORA",
"middle_name": "VAUGHN",
"credential": "CDCI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-01",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AK",
"license": "2673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wrangell, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.