Keith Lee Williams, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-202563 Issued in ID

Practice address

3771 N Eagle Rd
Boise, ID 83713-5005

Phone

(208) 939-9917

Fax

(888) 505-3331

NPI assigned

Aug 23, 2007

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

Enrolled in ID

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Williams Psychology Inc.

  • Clinical Psychologist
  • Boise, ID
  • NPI 1982943478
  Medicare reassignment NPD Authorized official
• Mountain States Counseling & Psychological Services PLLL

  • Psychologist
  • Boise, ID
  • NPI 1598959322
  Medicare reassignment NPD

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1174716005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3771 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135005",
            "telephone_number": "208-939-9917",
            "fax_number": "888-505-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3771 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135005",
            "telephone_number": "208-939-9917",
            "fax_number": "888-505-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KEITH",
        "middle_name": "LEE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY-202563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivy Shandel Williams, LMSW
• Jessica Leann Williams, LCSW
• John D Williams, MD
• Kathryn Williams, L.M.T.
• Kayla Simone Williams, DO
• Kennedy Williams
• Kenneth Williams
• McKenzie Williams, WHNP
• Mendy Williams
• Michael Forrest Williams Sr., D.C.

• Clinical Psychologist in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; 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.