NPIMap

Organization Active NPI

Formwalt and Williams Inc

  • Clinical Psychologist
  • Mobile, AL
National Provider Identifier
1043304835
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
504 Issued in AL
Legal business name
FORMWALT AND WILLIAMS INC
Practice address
7305 Cottage Hill Road
Mobile, AL 36695
Phone
(251) 776-1217
Fax
(251) 776-1219
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Joyelle Reed
Title
Office Manager
Phone
(251) 776-1217

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 504 AL Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 593 AL

Addresses

Primary practice location

7305 Cottage Hill Road
Mobile, AL 36695

Mailing address

Post Office Box 850818
Mobile, AL 36685-0818
Phone (251) 776-1217

Other identifiers 2

IdentifierTypeStateIssuer
R38382OtherBC & BS DR ANNIE FORMWALT
R82618OtherBCBS DR LUCILE T WILLIAMS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1043304835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 850818",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366850818",
            "telephone_number": "251-776-1217",
            "fax_number": "251-776-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 COTTAGE HILL ROAD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36695",
            "telephone_number": "251-776-1217",
            "fax_number": "251-776-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMWALT AND WILLIAMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "JOYELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "251-776-1217",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "504",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "593",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC & BS DR ANNIE FORMWALT",
            "identifier": "R38382",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DR LUCILE T WILLIAMS",
            "identifier": "R82618",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.