Active NPI
Mary Florence Williams, LCSW
- Mental Health Counselor
- South Prince George, VA
National Provider Identifier
1912759481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0904015758
- Practice address
- 10531 S Crater Rd
South Prince George, VA 23805-7333 - Phone
- (804) 431-5820
- NPI assigned
- Apr 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0904015758 | VA | Primary |
Addresses
Primary practice location
10531 S Crater Rd
South Prince George, VA 23805-7333
Mailing address
1613 River Rock Rd Apt 101
Chester, VA 23836-6188
Phone (804) 919-1199
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0904015758 | VA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712275200000",
"number": "1912759481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1613 RIVER ROCK RD APT 101",
"city": "CHESTER",
"state": "VA",
"postal_code": "238366188",
"telephone_number": "804-919-1199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10531 S CRATER RD",
"city": "SOUTH PRINCE GEORGE",
"state": "VA",
"postal_code": "238057333",
"telephone_number": "804-431-5820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MARY",
"middle_name": "FLORENCE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-05",
"last_updated": "2024-04-05",
"certification_date": "2024-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0904015758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Prince George, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.