Individual provider Active NPI

Mark L Williams, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1851389910
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34002500A Issued in IN
Practice address
8202 Clearvista Pkwy
Suite 6a
Indianapolis, IN 46256-1400
Phone
(317) 288-9942
Fax
(317) 288-9945
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34002500A IN Primary

Addresses

Primary practice location

8202 Clearvista Pkwy
Suite 6a
Indianapolis, IN 46256-1400

Mailing address

8202 Clearvista Pkwy
Suite 6a
Indianapolis, IN 46256-1400
Phone (317) 288-9942

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
34002500AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1851389910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8202 CLEARVISTA PKWY",
            "address_2": "SUITE 6A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561400",
            "telephone_number": "317-288-9942",
            "fax_number": "317-288-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 CLEARVISTA PKWY",
            "address_2": "SUITE 6A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561400",
            "telephone_number": "317-288-9942",
            "fax_number": "317-288-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34002500A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.