Active NPI
Russell Howard Williams, PSY.D.
- Clinical Psychologist
- Louisville, KY
National Provider Identifier
1265820211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1314
- Practice address
- 11803 Robindale Rd
Louisville, KY 40243-1338 - Phone
- (502) 550-2535
- Fax
- (502) 244-2566
- NPI assigned
- Dec 29, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1314 | KY | Primary |
| Forensic Psychologist | 103TF0200X | 1314 | KY |
Addresses
Primary practice location
11803 Robindale Rd
Louisville, KY 40243-1338
Mailing address
11803 Robindale Rd
Louisville, KY 40243-1338
Phone (502) 550-2535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1314 | KY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419811200000",
"number": "1265820211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11803 ROBINDALE RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402431338",
"telephone_number": "502-550-2535",
"fax_number": "502-244-2566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11803 ROBINDALE RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402431338",
"telephone_number": "502-550-2535",
"fax_number": "502-244-2566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "RUSSELL",
"middle_name": "HOWARD",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-12-29",
"last_updated": "2014-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KY",
"license": "1314",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "KY",
"license": "1314",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.