Maris Autumn Williams, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

18073 Issued in NC

Practice address

10551 Paces Ave Apt 526
Matthews, NC 28105-2713

Phone

(704) 654-8406

NPI assigned

Sep 12, 2022

Last updated

Aug 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrative Wellness Solutions, PLLC

  dba LifeStance Health

  • Psychologist
  • Mooresville, NC
  • NPI 1447760871

  Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1811619356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10551 PACES AVE APT 526",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281052713",
            "telephone_number": "704-654-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10551 PACES AVE APT 526",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281052713",
            "telephone_number": "704-654-8406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13840 Ga Highway 23 N",
            "address_purpose": "LOCATION",
            "city": "Metter",
            "state": "GA",
            "postal_code": "304398649",
            "country_code": "US",
            "telephone_number": "704-654-8406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARIS",
        "middle_name": "AUTUMN",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A18073",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "18073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Joseph Williams, D.P.M.
• Chelsea Marie Williams, PA-C
• Hillary Michelle Williams
• Leslie Williams, LCSW, CCTP
• Lydia Mary Williams, OTR/L
• Megan Williams
• Monica Catrice Williams, LCSWA
• Venecia Williams, HAIR LOSS SPECIALIST
• Eden Rose Williamson
• Shirletta Ross Williamson, LCAS, CCS, QSAP, QMH

• Mental Health Counselor in Matthews, NC
• Providers in Matthews, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.