Active NPI
Kimberly Williams, PSY.D.
- Clinical Neuropsychologist
- Great Neck, NY
National Provider Identifier
1043590854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 68018072
- Practice address
- 935 Northern Blvd. Suite 203
Great Neck, NY 11021 - Phone
- (516) 512-1215
- Fax
- (516) 513-1217
- NPI assigned
- Aug 24, 2011
- Sex
- Female
- 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 Neuropsychologist | 103G00000X | 68018072 | NY | Primary |
Addresses
Primary practice location
935 Northern Blvd. Suite 203
Great Neck, NY 11021
Mailing address
935 Northern Blvd. Suite 203
Great Neck, NY 11021
Phone (516) 512-1215
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68018072 | NY | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314144000000",
"number": "1043590854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "935 NORTHERN BLVD. SUITE 203",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "11021",
"telephone_number": "516-512-1215",
"fax_number": "516-513-1217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 NORTHERN BLVD. SUITE 203",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "11021",
"telephone_number": "516-512-1215",
"fax_number": "516-513-1217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KIMBERLY",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-24",
"last_updated": "2011-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NY",
"license": "68018072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.