Jeffrey Michael Williamson, PH D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY0004728 Issued in FL

Practice address

3700 N Harbor City Blvd
Ste 1D
Melbourne, FL 32935-5764

Phone

(321) 610-4703

Fax

(321) 622-5948

NPI assigned

Aug 31, 2006

Last updated

Jul 12, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Jeffrey M Williamson PHD LLC

  • Clinical Psychologist
  • Melbourne, FL
  • NPI 1083101570
  NPD Authorized official
• Medical Associates of Brevard LLC

  • Multi-Specialty Clinic/Center
  • Melbourne, FL
  • NPI 1861400103
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1114038916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 N HARBOR CITY BLVD",
            "address_2": "STE 1D",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355764",
            "telephone_number": "321-610-4703",
            "fax_number": "321-622-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 N HARBOR CITY BLVD",
            "address_2": "STE 1D",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355764",
            "telephone_number": "321-610-4703",
            "fax_number": "321-622-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "credential": "PH D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY0004728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Patricia Williams, APRN
• Steven Andrew Williams
• Steven D Williams, MD
• Tacheika Williams, RBT
• Vincent Michael Williams, DC, MS, LAT, ATC
• Terri G Williamson, LMHC
• Cynthia McLurkin Williford, ARNP
• Michael Willis, M.D.
• Tina A. Wills, COTA
• Tracy Wills, LMHC

• Psychologist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.