Jacqueline Gamble Williams, ASSESSMENT SPECIALIS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

390 Park St
Jacksonville, FL 32204-2342

Phone

(904) 899-6300

NPI assigned

May 29, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• River Region Human Services Inc

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1568507853
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790986693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 NETTLEBROOK ST S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322181007",
            "telephone_number": "904-714-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322042342",
            "telephone_number": "904-899-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACQUELINE",
        "middle_name": "GAMBLE",
        "credential": "ASSESSMENT SPECIALIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harry D Williams
• Heather Williams, ARNP
• Heather Elaine Williams, PA
• Heather Vogel Williams, M.D.
• Hugh Williams, MD
• Jah'Nai Talleah Williams, DPT
• Jalisa Williams
• James B. Williams Jr., PHD
• Janice V Williams
• Jasirah Damaris Williams

• Addiction (Substance Use Disorder) Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Addiction (Substance Use Disorder) Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.