Active NPI
Paul Williams, PCC, LICDC
- Professional Counselor
- Worthington, OH
National Provider Identifier
1922110568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E0004239
- Practice address
- 77 E Wilson Bridge Rd
Suite 101
Worthington, OH 43085-2365 - Phone
- (440) 225-8857
- Fax
- (614) 310-3320
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E0004239 | OH | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 944129 | OH | |
| Mental Health Counselor | 101YM0800X | E0004239 | OH | |
| Pastoral Counselor | 101YP1600X | E0004239 | OH | |
| Marriage & Family Therapist | 106H00000X | E0004239 | OH |
Addresses
Primary practice location
77 E Wilson Bridge Rd
Suite 101
Worthington, OH 43085-2365
Mailing address
77 E Wilson Bridge Rd
Suite 101
Worthington, OH 43085-2365
Phone (440) 225-8857
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922110568 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 944129 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| E0004239 | OH | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369353600000",
"number": "1922110568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 E WILSON BRIDGE RD",
"address_2": "SUITE 101",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430852365",
"telephone_number": "440-225-8857",
"fax_number": "614-310-3320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 E WILSON BRIDGE RD",
"address_2": "SUITE 101",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430852365",
"telephone_number": "440-225-8857",
"fax_number": "614-310-3320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "PAUL",
"credential": "PCC, LICDC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2013-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E0004239",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "944129",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E0004239",
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "OH",
"license": "E0004239",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OH",
"license": "E0004239",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1922110568",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worthington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.