Active NPI
Daniel Jeremy Williger, PH.D.
- Clinical Psychologist
- Saint Louis, MO
National Provider Identifier
1013011634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 01435
- Practice address
- 10820 Sunset Office Dr 210
Saint Louis, MO 63127-1030 - Phone
- (314) 712-0365
- Fax
- (314) 549-8807
- NPI assigned
- Sep 12, 2006
- Last updated
- Nov 30, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 01435 | MO | Primary |
Addresses
Primary practice location
10820 Sunset Office Dr 210
Saint Louis, MO 63127-1030
Mailing address
10820 Sunset Office Dr 210
Saint Louis, MO 63127-1030
Phone (314) 712-0365
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA2526 | Other | MO | MEDICARE PTAN |
| 493524300 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01435 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Living Truth Counseling Services, LLC | Past | Accepting new patients | |
| Open Gate Therapy LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Saint Louis, MO
- NPI 1114199031
-
dba Open Gate Therapy
- Community/Behavioral Health Agency
- Saint Louis, MO
- NPI 1124580501
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448841600000",
"number": "1013011634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10820 SUNSET OFFICE DR 210",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631271030",
"telephone_number": "314-712-0365",
"fax_number": "314-549-8807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10820 SUNSET OFFICE DR 210",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631271030",
"telephone_number": "314-712-0365",
"fax_number": "314-549-8807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIGER",
"first_name": "DANIEL",
"middle_name": "JEREMY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-12",
"last_updated": "2015-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "01435",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "MA2526",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "493524300",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.