Serena Rae Williams, CLC, CD

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

Practice address

622 Carlisle Ave
Dayton, OH 45410-2737

Phone

(937) 522-1816

NPI assigned

Oct 28, 2019

Reactivated

Aug 11, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1861035347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 CARLISLE AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454102737",
            "telephone_number": "937-522-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 CARLISLE AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454102737",
            "telephone_number": "937-522-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SERENA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "CLC, CD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "deactivation_date": "2021-11-02",
        "reactivation_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Williams
• Robin Louise Williams, LPN
• Ron-Jalia Williams
• Sandra Gail Williams, RN
• Sandra Kaye Williams, RN
• Shahnice Leigh Williams, CDCA-P
• Shantae M Williams, RN
• Shawna M Williams, DPT
• Shelia Francine Williams, MS, RN
• Shiann Williams

• Lactation Consultant (Non-RN) in Dayton, OH
• Providers in Dayton, OH by specialty
• Lactation Consultant (Non-RN) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.