Individual provider Active NPI

David John Williams, PH.D., M.P.

  • Prescribing (Medical) Psychologist
  • Monroe, LA
National Provider Identifier
1104953769
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
MPAP.000033 Issued in LA
Practice address
1410 Royal Ave
Monroe, LA 71201-5608
Phone
(318) 998-3511
Fax
(318) 322-9492
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X MP.0953 LA
Prescribing (Medical) Psychologist 103TP0016X MPAP.000033 LA Primary

Addresses

Primary practice location

1410 Royal Ave
Monroe, LA 71201-5608

Mailing address

1410 Royal Ave
Monroe, LA 71201-5608
Phone (318) 998-3511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20040927000106 LA Practitioner - Clinical Psychologist 5496724676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Williams Consulting Inc.Group PAC ID 6305883919, 4 clinicians

Practice addresses (Care Compare)

1410 Royal Ave
Monroe, LA 71201-5608
Phone (318) 998-3511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MP.0953LAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Consulting Inc. Prescribing (Medical) CurrentSince Feb 28, 2004 Accepting new patients
Premier Hope Orthotic & Prosthetic Enterprises LLC Past Accepting new patients

Locations

1209 Royal Ave
Monroe, LA 71201
Phone (318) 812-0119

1410 Royal Ave
#J
Monroe, LA 71201
Phone (318) 998-3511

1410 Royal Ave
Monroe, LA 71201
Phone (318) 322-0062

Organizations & group practices 2

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1104953769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 ROYAL AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015608",
            "telephone_number": "318-998-3511",
            "fax_number": "318-322-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 ROYAL AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015608",
            "telephone_number": "318-998-3511",
            "fax_number": "318-322-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D., M.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "MP.0953",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "LA",
            "license": "MPAP.000033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.