Individual provider Active NPI

Michael Jerome Williams, L.P.C.

  • Professional Counselor
  • Saint Louis, MO
National Provider Identifier
1841343662
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
000331 Issued in MO
Practice address
9155 Hemis Fair Dr
Saint Louis, MO 63136-4006
Phone
(314) 898-5218
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 000331 MO Primary
Massage Therapist 225700000X 2004003080 MO

Addresses

Primary practice location

9155 Hemis Fair Dr
Saint Louis, MO 63136-4006

Mailing address

9155 Hemis Fair Dr
Saint Louis, MO 63136-4006
Phone (314) 898-5218

Other identifiers 1

IdentifierTypeStateIssuer
493267322MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12220 Glenpark Dr
Maryland Heights, MO 63043-4226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000331MOMDProfessional Counselor
2004003080MOMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1841343662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9155 HEMIS FAIR DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631364006",
            "telephone_number": "314-898-5218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 HEMIS FAIR DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631364006",
            "telephone_number": "314-898-5218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MICHAEL",
        "middle_name": "JEROME",
        "name_prefix": "Mr.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "000331",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MO",
            "license": "2004003080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493267322",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.