Individual provider Active NPI

Monty Michael Williams, AOD COUNSELOR

  • Addiction (Substance Use Disorder) Counselor
  • Colton, CA
National Provider Identifier
1962848648
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
RW7035 Issued in CA
Practice address
2275 E Cooley Dr
Colton, CA 92324-6324
Phone
(909) 370-1777
Fax
(909) 370-1776
NPI assigned
May 21, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X RW7035 CA Primary

Addresses

Primary practice location

2275 E Cooley Dr
Colton, CA 92324-6324

Mailing address

6888 Mendocino Dr
Riverside, CA 92503-1037
Phone (951) 642-8392

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

LicenseStateTypeSpecialty
RW7035CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1962848648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6888 MENDOCINO DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925031037",
            "telephone_number": "951-642-8392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 E COOLEY DR",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923246324",
            "telephone_number": "909-370-1777",
            "fax_number": "909-370-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MONTY",
        "middle_name": "MICHAEL",
        "credential": "AOD COUNSELOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RW7035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

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

Verify at the official NPI Registry.