Shirley Williams, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP008260 Issued in GA

Practice address

1074 Bexhill Dr
Lawrenceville, GA 30043-6693

Phone

(646) 271-0617

NPI assigned

Jul 31, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1104172840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 BEXHILL DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1074 BEXHILL DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436693",
            "telephone_number": "646-271-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHIRLEY",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-31",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "022059",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SLP",
            "identifier": "022059",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myreon Williams, M.D.
• Phillip George Williams
• Rebecca Lynn Williams, M.D.
• Shayla Raielle Williams, RN
• Shira Brey Williams, MS, ATC, LAT, ITAT
• Tasheeka N Williams, CPNP
• Teresa Peggy Williams
• Toni Nicole Williams, RN
• Victoria Renee Williams, LPN
• Ashley Janelle Williamson

• Speech-Language Pathologist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.