MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC) – Professional Counselor, NPI 1720338627

MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC) is a healthcare provider. based in Woodbridge, Virginia. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials NCC, LPC. They hold a License No. 0701005312 (VA). The NPI Number for MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC) is 1720338627

Main info

Male
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC)
NPI
1720338627
Phone
(571) 316-1020
Address
12890 HARBOR DR
Enumeration Date
18 September 2012
Last Update Date
14 December 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2008 (18 years ago)
PAC ID
7517297161
Professional Enrollment ID
I20240415004076
Address ID
VA220251602Du4191XDRXX300

Contacts

Secure Messaging
nicholas.williams@indeliblechanges.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness85
Years active:13State licenses:1Other namesUpdated within 12 months

1,998 MENTAL HEALTH COUNSELOR in VA

Provider Addresses for MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC)

  • 12890 HARBOR DR

    WOODBRIDGE, VA 221922921

    Phone: (571) 316-1020

    Type: Location

  • 4191 WATERWAY DR

    DUMFRIES, VA 220251602

    Phone: (703) 474-0585

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240415004076IMental Health CounselorVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 22192)

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Reviews

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Frequently asked questions

What NPI should I save for MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC)?
Save NPI 1720338627 if you need a stable reference for MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC).
Is MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC)'s specialty in plain language?
Clinically, the directory lists MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC) with Professional Counselor. Clinical services aligned with this taxonomy classification.
Does MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC) practice in Virginia?
You will see Woodbridge, Virginia on file for MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC) alongside any extra practice locations.
Is MR. NICHOLAS ANTONIO WILLIAMS (NCC, LPC) a real provider?
This page reflects official NPPES data for NPI 1720338627. Always confirm identity and privileges with the practice and licensing boards.

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