Michael Andrew Williston, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

B1-0011487 Issued in DE

Practice address

4000 Nexus Dr Ste Ne3-100
Wilmington, DE 19803-3000

Phone

(302) 320-9771

Fax

(302) 623-7964

NPI assigned

Oct 17, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Michael Andrew Holston Former name

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/

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.

• Christiana Care Health Services, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Wilmington, DE
  • NPI 1770568107
  Medicare reassignment Care Compare group NPD
• Christianacare Virtual Health Practice PA

  • Family Medicine Physician
  • Wilmington, DE
  • NPI 1619562410
  Medicare reassignment NPD
• Christiana Care Health Services, Inc

  • Psychiatry Physician
  • Wilmington, DE
  • NPI 1083699433

  Psychologist

  NPD
• Christianacare Virtual Health Practice PA

  • Pulmonary Disease Physician
  • Wilmington, DE
  • NPI 1740901701
  NPD
• Christiana Care Health Services Inc

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD
• Christiana Care Health Services Inc

  • Infectious Disease Physician
  • Wilmington, DE
  • NPI 1326022476
  NPD (past)
• Christiana Care Health Services, Inc

  • Cardiovascular Disease Physician
  • Newark, DE
  • NPI 1003850504
  NPD (past)

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1093090474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021512",
            "telephone_number": "215-568-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 NEXUS DR STE NE3-100",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033000",
            "telephone_number": "302-320-9771",
            "fax_number": "302-623-7964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021512",
            "country_code": "US",
            "telephone_number": "215-568-0860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLISTON",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-17",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DE",
            "license": "B1-0011487",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS017269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "HOLSTON",
            "middle_name": "ANDREW",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Wilmington Ambulatory Surgical Center, LLC
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• Psychologist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Psychologist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.