Individual provider Active NPI

Darlene Williams, PHD

  • Clinical Psychologist
  • Palm Harbor, FL
National Provider Identifier
1154597128
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY5540 Issued in FL
Practice address
3060 Alt 19
Ste. B-12
Palm Harbor, FL 34683
Phone
(727) 467-4213
NPI assigned
Apr 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY5540 FL Primary

Addresses

Primary practice location

3060 Alt 19
Ste. B-12
Palm Harbor, FL 34683

Mailing address

2625 Keystone Rd Ste a-4
Tarpon Springs, FL 34688-7436
Phone (727) 467-4213

Other identifiers 1

IdentifierTypeStateIssuer
54118BOtherFLMEDICARE INDIVIDUAL PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050308000315 FL Practitioner - Clinical Psychologist 6709830359 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13039 W Linebaugh Ave
Tampa, FL 33626-4483
Phone (727) 467-4213

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Wellness Group LLC Clinical CurrentSince Feb 24, 2013 Accepting new patients
Darlene Williams PH D PA Clinical CurrentSince Jul 16, 2012 Accepting new patients
B. Ronald Lopez, M.D.P.a. Past Accepting new patients

Locations

1227 S Myrtle Ave
Clearwater, FL 33756
Phone (727) 449-2628

3260 N McMullen Booth Rd
Clearwater, FL 33761
Phone (727) 726-5090

3060 Alt 19
Ste B12
Palm Harbor, FL 34683
Phone (727) 467-4213

34876 US Highway 19 N
Palm Harbor, FL 34684
Phone (727) 216-3972

13039 W Linebaugh Ave
Ste 101
Tampa, FL 33626
Phone (352) 515-6914

13039 W Linebaugh Ave
Tampa, FL 33626
Phone (727) 467-4213

Organizations & group practices 3

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": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1154597128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 KEYSTONE RD STE A-4",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346887436",
            "telephone_number": "727-467-4213",
            "fax_number": "727-479-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 ALT 19",
            "address_2": "STE. B-12",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34683",
            "telephone_number": "727-467-4213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DARLENE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY5540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PROVIDER ID",
            "identifier": "54118B",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.