Individual provider Active NPI

Taylor Williams

  • Mental Health Counselor
  • Columbus, OH
National Provider Identifier
1992219380
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2002039 Issued in OH
Practice address
16 W Long St
Columbus, OH 43215-2815
Phone
(614) 255-0990
NPI assigned
Nov 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OH
Mental Health Counselor 101YM0800X E.2002039 OH Primary

Addresses

Primary practice location

16 W Long St
Columbus, OH 43215-2815

Mailing address

16 W Long St
Columbus, OH 43215-2815

Other names 1

  • Taylor Kidwell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221020001297 OH Practitioner - Other (Non-Physician) 6305212051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast IncGroup PAC ID 8426014853, 48 clinicians

Practice addresses (Care Compare)

16 W Long St
Columbus, OH 43215-2815
Phone (614) 225-0990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.2002039OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast, Inc CurrentSince Apr 6, 2024 Accepting new patients
Southeast, Inc CurrentSince Apr 6, 2024 Accepting new patients

Locations

16 W Long St
Columbus, OH 43215

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": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1992219380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 W LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 W LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152815",
            "telephone_number": "614-255-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-22",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2002039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "KIDWELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.