Mr Nicholas Antonio Williams, NCC, LPC in Woodbridge, VA

Mr Nicholas Antonio Williams, NCC, LPC is a medicare enrolled "Counselor - Professional" provider in Woodbridge, Virginia. His current practice location is 12890 Harbor Dr, Woodbridge, Virginia. You can reach out to his office (for appointments etc.) via phone at (571) 316-1020.

Mr Nicholas Antonio Williams is licensed to practice in Virginia (license number 0701005312) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720338627.

Contact Information

	Mr Nicholas Antonio Williams, NCC, LPC
	12890 Harbor Dr, Woodbridge, VA 22192-2921
	(571) 316-1020
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Nicholas Antonio Williams
Gender	Male
Speciality	Counselor - Professional
Location	12890 Harbor Dr, Woodbridge, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720338627
Provider Enumeration Date: 09/18/2012
Last Update Date: 12/14/2022

Medicare PECOS Information:

PECOS PAC ID: 7517297161
Enrollment ID: I20240415004076

Medical Identifiers

Medical identifiers for Mr Nicholas Antonio Williams such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720338627	NPI	-	NPPES
2013135052	Medicaid	VA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	0701005312 (Virginia)	Secondary
101YM0800X	Counselor - Mental Health	(* (Not Available))	Secondary
101YM0800X	Counselor - Mental Health	0701005312 (Virginia)	Secondary
101YP2500X	Counselor - Professional	0701005312 (Virginia)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Nicholas Antonio Williams allows following entities to bill medicare on his behalf.

Entity Name	Indelible Changes, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720540107 PECOS PAC ID: 9234578808 Enrollment ID: O20240415004072

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Nicholas Antonio Williams is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Nicholas Antonio Williams, NCC, LPC 4191 Waterway Dr, Dumfries, VA 22025-1602 Ph: (703) 474-0585	Mr Nicholas Antonio Williams, NCC, LPC 12890 Harbor Dr, Woodbridge, VA 22192-2921 Ph: (571) 316-1020

Reviews and Comments

Counselor in Woodbridge, VA

Addie Mae Brown, LPC, LMFT, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 13000 Harbor Center Dr Ste 352, Woodbridge, VA 22192 Phone: 703-270-1017
Elizabeth Sue Wyman, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4899 Prince William Pkwy, Woodbridge, VA 22192 Phone: 833-510-4357
Mr. Dekiegai Eleazer Reeves, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14786 Barksdale St, Woodbridge, VA 22193 Phone: 703-864-4561
Caitlin Lisee, Counselor Medicare: Not Enrolled in Medicare Practice Location: 13000 Harbor Center Dr Ste 301, Woodbridge, VA 22192 Phone: 703-492-2994
Mr. Michael Howard Borash, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1388 Old Bridge Rd, Woodbridge, VA 22192 Phone: 800-799-1212 Fax: 703-492-7768
Ms. Megan Yvonne Hess, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1954 Opitz Blvd Ste 7, Woodbridge, VA 22191 Phone: 703-492-2924
Teresa Ann George, MA,LPC,NCC Counselor Medicare: Medicare Enrolled Practice Location: 2501 Hunter Pl Ste 202, Woodbridge, VA 22192 Phone: 571-365-3172

Mr Nicholas Antonio Williams, NCC, LPC - Medicare Counselor in Woodbridge, VA