Individual provider Active NPI

Renee Kathleen Williams, LCSW

  • Clinical Social Worker
  • Chandler, AZ
National Provider Identifier
1861234510
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-22597 Issued in AZ
Practice address
1948 N Hamilton PL
Chandler, AZ 85225-8425
Phone
(602) 301-4771
Fax
(480) 452-0891
NPI assigned
Jun 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2025

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 LCSW-22597 AZ Primary

Addresses

Primary practice location

1948 N Hamilton PL
Chandler, AZ 85225-8425

Mailing address

1948 N Hamilton PL
Chandler, AZ 85225-8425
Phone (602) 301-4771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20250331001046 AZ Practitioner - Clinical Social Worker 6709309834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-22597AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom and Prosper Therapy Clinical PastSince Jun 16, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1861234510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1948 N HAMILTON PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852258425",
            "telephone_number": "602-301-4771",
            "fax_number": "480-452-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1948 N HAMILTON PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852258425",
            "telephone_number": "602-301-4771",
            "fax_number": "480-452-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RENEE",
        "middle_name": "KATHLEEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-22597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.