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EZRA BRANDON WILLIAMSON I LPC
NPI 1942953823
Counselor - Professional in Green Bay, WI

Active since January 31, 2022PECOS EnrolledAccepts Medicare Assignment
480 PILGRIM WAY # 1300-A, GREEN BAY, WI 54304(920) 610-5119(920) 610-5120 Get Directions Write a Review

NPPES record last updated: January 8, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 8, 2025, Jan 31, 2022 (2 updates tracked since 2022).

About Ezra Brandon Williamson I Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EZRA BRANDON WILLIAMSON I LPC (NPI 1942953823) is an individual professional provider in Green Bay, Wisconsin, licensed in Wisconsin (11415) and active in the NPI registry since January 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1942953823
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameEZRA BRANDON WILLIAMSON ICredential: LPC
Location Address480 PILGRIM WAY # 1300-AGreen Bay, WI 54304-5280
Mailing Address1900 Silver Lake Rd Nw Ste 110New Brighton, MN 55112-1789 · (651) 464-6671 · Fax (651) 628-0411
Phone(920) 610-5119
Fax(920) 610-5120
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJanuary 31, 2022
Last NPPES UpdateJanuary 8, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 8, 2025
✔ NPI 1942953823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in WI · 11415
480 PILGRIM WAY # 1300-A, Green Bay, WI 54304
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Dean Health Plan, HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ezra Brandon Williamson I Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1254850324
PECOS Enrollment IDI20250522000683
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ezra Williamson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Nystrom & Associates Counseling Wi., S.C.
166 mi
Mental Health (Including Community Mental Health Center)
201 MAIN ST STE 500
La Crosse, WI 54601
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Nystrom & Associates Counseling Wi Sc
  • 133 clinicians in this Medicare group
NPI 1659977866 (651) 379-1750

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. TRICIA ANN KERKER LPC
Counselor (Professional)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
HOLLIE C SMET LPC
Counselor (Professional)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
DR. KIMBERLY K WALKER-DANIELS DNP-PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
MISS KERRY A TALBERT NP
Nurse Practitioner (Psychiatric/Mental Health)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
STEPHANIE M KREGEL-FORBES MSE, LPC
Counselor (Professional)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
ABIGAIL RUSSELL LCSW
Social Worker (Clinical)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
AUTUMN MARIE SCHLEIS LPC
Counselor (Professional)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
MS. LAUREN ELIZABETH GIDLEY MSE, LPC, SAC-IT
Counselor (Mental Health)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ezra Williamson's NPI number?

The NPI number for Ezra Williamson is 1942953823. It was assigned to this individual provider in the NPPES registry on January 31, 2022.

Where is Ezra Williamson located?

Ezra Williamson practices at 480 Pilgrim Way # 1300-A, Green Bay, WI 54304. The listed phone number is (920) 610-5119.

What is Ezra Williamson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Ezra Williamson enrolled in Medicare?

Yes. Ezra Williamson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Ezra Williamson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ezra Williamson reassigns Medicare benefits to Nystrom & Associates Counseling Wi., S.C. (La Crosse, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ezra Williamson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ezra Williamson accept?

Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, HealthPartners, Quartz and Security Health Plan and 1 other insurer list Ezra Williamson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ezra Williamson was last updated on January 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.