NPIMap

Individual provider Active NPI

William L Mulligan, PHD

  • Clinical Psychologist
  • Chesapeake, VA
National Provider Identifier
1063406478
Registry record updated Jul 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810000729 Issued in VA
Practice address
1403 Greenbrier Pkwy
Suite 215
Chesapeake, VA 23320-0614
Phone
(757) 410-0700
Fax
(757) 222-3384
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810000729 VA Primary

Addresses

Primary practice location

1403 Greenbrier Pkwy
Suite 215
Chesapeake, VA 23320-0614

Mailing address

PO Box 4085
Virginia Beach, VA 23454-0085
Phone (757) 410-0700

Other identifiers 9

IdentifierTypeStateIssuer
172017, 267207OtherVAANTHEM, BC/BS
2149701OtherVAUBH
54-1088477OtherTRICARE
54-1088477OtherVAVIRGINIA HEALTH NETWORK
54-1088477OtherVAAETNA
031538OtherVALUE OPTIONS
089211, 37077OtherVAOPTIMAHEALTH
11240084OtherVACAQH
2166701OtherVACBH

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

LicenseStateTypeSpecialty
0810000729VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cognitive Behavior Therapy Center PastSince May 9, 2021 Accepting new patients
Eden Counseling Center PastSince Dec 1, 2006 Accepting new patients
Curtis Bryan MD LTD Past Accepting new patients
Claudia Brown, Inc Past Accepting new patients
Patient Choice Ghent Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341619200000",
    "number": "1063406478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4085",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234540085",
            "telephone_number": "757-410-0700",
            "fax_number": "757-222-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 GREENBRIER PKWY",
            "address_2": "SUITE 215",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200614",
            "telephone_number": "757-410-0700",
            "fax_number": "757-222-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2012-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810000729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM, BC/BS",
            "identifier": "172017, 267207",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "2149701",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "54-1088477",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "54-1088477",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "54-1088477",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "031538",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMAHEALTH",
            "identifier": "089211, 37077",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11240084",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBH",
            "identifier": "2166701",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2012; 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.