Individual provider Active NPI

Bronwen Elizabeth Williams, PH.D.

  • Clinical Psychologist
  • Gaithersburg, MD
National Provider Identifier
1164589883
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2764 Issued in MD
Practice address
16220 S Frederick Ave Ste 512
Gaithersburg, MD 20877-4022
Phone
(301) 977-7782
Fax
(301) 977-8287
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2764 MD Primary

Addresses

Primary practice location

16220 S Frederick Ave Ste 512
Gaithersburg, MD 20877-4022

Mailing address

8 Hearthstone CT
Rockville, MD 20854-2644
Phone (301) 977-7782

Other identifiers 1

IdentifierTypeStateIssuer
35230001OtherMDCAREFIRST BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20040517001575 DC Practitioner - Clinical Psychologist 7214927839 Practice locations: Rockville, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8 Hearthstone CT
Rockville, MD 20854-2644
Phone 30178537812

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2764MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wen-Li Lu,LLC Past Accepting new patients

Organizations & group practices 1

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164589883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 HEARTHSTONE CT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208542644",
            "telephone_number": "301-977-7782",
            "fax_number": "301-977-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16220 S FREDERICK AVE STE 512",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774022",
            "telephone_number": "301-977-7782",
            "fax_number": "301-977-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRONWEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "2764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS",
            "identifier": "35230001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.