Mark Gerard Williams Jr., LSW, LICDC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.1600228 Issued in OH

Practice address

310 W Lakeside Ave Ste 500
Cleveland, OH 44113-1069

Phone

(216) 443-8250

Fax

(216) 443-8272

NPI assigned

Jun 4, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cuyahoga County Tasc

  • Social Worker
  • Cleveland, OH
  • NPI 1811024433
  NPD (past)
• Cuyahoga County Tasc

  • Professional Counselor
  • Cleveland, OH
  • NPI 1922597210
  NPD (past)

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1962994111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W LAKESIDE AVE STE 500",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441131069",
            "telephone_number": "216-443-8250",
            "fax_number": "216-443-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W LAKESIDE AVE STE 500",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441131069",
            "telephone_number": "216-443-8250",
            "fax_number": "216-443-8272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1276 W 3rd St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441131512",
            "country_code": "US",
            "telephone_number": "216-443-7375",
            "fax_number": "216-443-8272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARK",
        "middle_name": "GERARD",
        "name_suffix": "Jr.",
        "credential": "LSW, LICDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1600228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke Williams, CNP
• Marc S Williams, MD
• Margot M Williams, MSW
• Maria Theresa Williams
• Marilyn Williams
• Martha Williams, CPNP
• Mary Kathryn Williams, CDCA, OCPSA
• Matthew Williams, TBS
• Melanie Patrice Williams
• Melissa Williams

• Social Worker in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; 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.