Andrea Michelle Williams, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05717 Issued in MD

Practice address

10665 Stanhaven PL Ste 3119
White Plains, MD 20695-3055

Phone

(301) 202-3739

Fax

(240) 602-6702

NPI assigned

Feb 14, 2017

Last updated

Apr 22, 2019By the provider in NPPES

Sex

Female

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

Enrolled in MD

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

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Create Your Life, LLC

  • Professional Counselor
  • White Plains, MD
  • NPI 1639529407
  Medicare reassignment

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1114466869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 VANE CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021526",
            "telephone_number": "301-202-3739",
            "fax_number": "301-885-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10665 STANHAVEN PL STE 3119",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953055",
            "telephone_number": "301-202-3739",
            "fax_number": "240-602-6702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Post Office Rd",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206021912",
            "country_code": "US",
            "telephone_number": "301-848-0461",
            "fax_number": "301-885-0922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-14",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• White Plains Health Care LLC (Restore Health Rehabilitation Center)
• White Plains Primary Care
• Andrea White
• Stephanie Wilcher, PHARMD
• Gladys Ann Wilkins, PA-C
• Ryleigh Elaine Wilson, PTA
• Mary Winkler
• Wooten Lyons LLC
• Phylicia Wooten, LCPC
• Huijing Yang

• Clinical Psychologist in White Plains, MD
• Providers in White Plains, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.