JEFFERSON WILLIAMS (NPI# 1891286191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891286191 |
| Entity Type | Individual |
| Full Name | JEFFERSON WILLIAMS |
| Credential | LCPC |
| Practice Address |
211 N Veterans Pkwy Ste 1 Bloomington IL 61704-3568 |
| Practice Telephone | 3096632229 |
| Mailing Telephone | 3096632229 |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2018-05-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180004426 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891252979 | Jefferson Williams Jr. | Counselor | 3634 Walton Way Ext, Augusta, GA 30909-1833 | 2019-02-26 |
| 1235381435 | Jefferson Gary Williams | Emergency Medicine | 170 Manning Drive, Cb# 7594, Unc Dept of Emergency Medicine, Chapel Hill, NC 27599-7594 | 2008-10-21 |
| Street Address |
211 N VETERANS PKWY STE 1 |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-3568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427523695 | Kiera Michelle Dymit | Counselor | 211 N Veterans Pkwy Ste 1, Bloomington, IL 61704-3568 | 2018-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265075162 | Angela Emily Brodine | Counselor | 5301 Hyland Greens Dr Apt 702, Bloomington, MN 55437-3909 | 2019-10-23 |
| 1184280141 | Holly Ann Wonders Myers | Counselor | 209 S Prospect Rd Ste 1, Bloomington, IL 61704-4697 | 2019-05-15 |
| 1326502246 | Jacqueline Clare Vermaat | Counselor | 418 N Main St Fl 1, Bloomington, IL 61701-3916 | 2019-01-24 |
| 1275006215 | Cameron Lee Small | Counselor | 9156 Vincent Ave S, Bloomington, MN 55431 | 2019-01-02 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1437663275 | Counseling Resource Institute LLC | Counselor | 2422 E Washington St Ste 107, Bloomington, IL 61704-1611 | 2017-11-30 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1457728206 | Faye Freeman-smith | Counselor | 2416 E Washington St Ste A2, Bloomington, IL 61704-1608 | 2015-08-27 |
| 1902289994 | John Leslie Freshour | Counselor | 616 Iaa Dr, Bloomington, IL 61701-2225 | 2015-07-08 |
| 1669851234 | Amy Leigh Strohman | Counselor | 5414 W Old Shakopee Cir, Bloomington, MN 55437-2766 | 2015-05-28 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.