Individual provider Active NPI

Phyllis Devon Williams, MA

  • Mental Health Counselor
  • Decatur, GA
National Provider Identifier
1891981320
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MFT001192 Issued in GA
Practice address
209 Swanton Way Ste a
102
Decatur, GA 30030-3274
Phone
(770) 710-7335
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MFC40719 CA
Mental Health Counselor 101YM0800X AL
Marriage & Family Therapist 106H00000X MFT001192 GA
Marriage & Family Therapist 106H00000X L336 AL
Mental Health Counselor 101YM0800X MFT001192 GA Primary
Marriage & Family Therapist 106H00000X MFC40719 CA

Addresses

Primary practice location

209 Swanton Way Ste a
102
Decatur, GA 30030-3274

Mailing address

2107 N Decatur Rd
205
Decatur, GA 30033-5305
Phone (770) 710-7335

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC40719CAMDMental Health Counselor
MFT001192GAMDMental Health Counselor
L336ALMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phyllis Williams, LMFT, PC Mental Health Past Accepting new patients

Organizations & group practices 1

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": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1891981320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 N DECATUR RD",
            "address_2": "205",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335305",
            "telephone_number": "770-710-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SWANTON WAY STE A",
            "address_2": "102",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303274",
            "telephone_number": "770-710-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PHYLLIS",
        "middle_name": "DEVON",
        "name_prefix": "Miss",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC40719",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001192",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AL",
            "license": "L336",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "MFT001192",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC40719",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.