Xavier Direll Willis, M.A.

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

Practice address

2867 Mayfield Rd Apt 1
Cleveland Heights, OH 44118-1633

Phone

(216) 645-8677

NPI assigned

Jan 9, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• United States Telepathy

  • Health Service Psychologist
  • Cleveland Heights, OH
  • NPI 1366236200
  NPD Authorized official

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1144934852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2867 MAYFIELD RD APT 1",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181633",
            "telephone_number": "216-645-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2867 MAYFIELD RD APT 1",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181633",
            "telephone_number": "216-645-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "XAVIER",
        "middle_name": "DIRELL",
        "name_prefix": "Prof.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101200000X",
            "taxonomy_group": "",
            "desc": "Drama Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.xavier.today/trose.html",
            "affiliation": "N",
            "endpointDescription": "My A.I. assistant",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2867 Mayfield Rd Apt 1",
            "city": "Cleveland Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441181633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Felicia Faye Williams
• Gwendolyn Williams
• Janice L Williams
• Kareem Williams
• Keena Williams
• Mikesha Monea Wilson
• Stephanie Monique Wilson
• Andrew Woconish, LPCC
• Aidan Joseph-Fitzroy Wolf
• Women'S Diagnostic Center of Cleveland, Inc.

• Health Service Psychologist in Cleveland Heights, OH
• Providers in Cleveland Heights, OH by specialty
• Health Service Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.