Individual provider Active NPI

William Eugene Williams, LCSW

  • Clinical Social Worker
  • Warner Robins, GA
National Provider Identifier
1871567693
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001694 Issued in GA
Practice address
1047 N Houston Rd
Warner Robins, GA 31093-1505
Phone
(478) 923-3762
Fax
(478) 923-0362
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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 001694 GA Primary

Addresses

Primary practice location

1047 N Houston Rd
Warner Robins, GA 31093-1505

Mailing address

PO Box 7737
Warner Robins, GA 31095-7737
Phone (478) 923-3762

Other identifiers 1

IdentifierTypeStateIssuer
055000354AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070330000139 GA Practitioner - Clinical Social Worker 6608970645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians

Practice addresses (Care Compare)

1345 Redmond Cir NW
Rome, GA 30165-1307
Phone (910) 742-9243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001694GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina Clinical CurrentSince Dec 1, 2020 Accepting new patients
United Psychology Center, LLC CurrentSince Nov 1, 2016 Accepting new patients
Lifesource of North Carolina Clinical CurrentSince Dec 1, 2020 Accepting new patients
Paul R Coplin MD PC Past Accepting new patients

Locations

2900 Chamblee Tucker Rd
Bldg 16
Chamblee, GA 30341
Phone (770) 939-1288

1345 Redmond Cir NW
Rome, GA 30165
Phone (706) 234-8281

Organizations & group practices 4

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1871567693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7737",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310957737",
            "telephone_number": "478-923-3762",
            "fax_number": "478-923-0362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1047 N HOUSTON RD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310931505",
            "telephone_number": "478-923-3762",
            "fax_number": "478-923-0362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "WILLIAM",
        "middle_name": "EUGENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "001694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055000354A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.