Individual provider Active NPI

Robert Lee Williams, LCSW

  • Clinical Social Worker
  • Maryville, TN
National Provider Identifier
1952774697
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8017 Issued in TN
Practice address
2030 Chilhowee Medical Park
Maryville, TN 37804-5285
Phone
(865) 982-3400
NPI assigned
Nov 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW133317 PA
Social Worker 104100000X LSW0000010371 TN
Clinical Social Worker 1041C0700X 8017 TN Primary

Addresses

Primary practice location

2030 Chilhowee Medical Park
Maryville, TN 37804-5285

Mailing address

PO Box 5209
Maryville, TN 37802-5209
Phone (865) 982-3400

Other identifiers 1

IdentifierTypeStateIssuer
Q071461MedicaidTN

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

LicenseStateTypeSpecialty
SW133317PAMDSocial Worker
LSW0000010371TNMDSocial Worker
8017TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Pathology Services of East Tennessee LLC Clinical PastSince Jan 26, 2022 Accepting new patients
Little Tennessee Valley Educational Cooperative PastSince Jan 26, 2022 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": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1952774697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5209",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378025209",
            "telephone_number": "865-982-3400",
            "fax_number": "865-238-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 CHILHOWEE MEDICAL PARK",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045285",
            "telephone_number": "865-982-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-03",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW133317",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "LSW0000010371",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "8017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q071461",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.