Active NPI
Henry A Willis, PHD
- Clinical Psychologist
- Washington, DC
National Provider Identifier
1275154577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 025791
- Practice address
- 3801 Georgia Ave NW Apt 303
Washington, DC 20011-5899 - Phone
- (601) 214-7193
- NPI assigned
- Apr 28, 2020
- 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 | 07423 | MD | |
| Clinical Psychologist | 103TC0700X | 025791 | NY | Primary |
Addresses
Primary practice location
3801 Georgia Ave NW Apt 303
Washington, DC 20011-5899
Mailing address
3801 Georgia Ave NW Apt 303
Washington, DC 20011-5899
Phone (601) 214-7193
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07423 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751846400000",
"number": "1275154577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 GEORGIA AVE NW APT 303",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200115899",
"telephone_number": "601-214-7193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 GEORGIA AVE NW APT 303",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200115899",
"telephone_number": "601-214-7193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "HENRY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-28",
"last_updated": "2025-07-07",
"certification_date": "2025-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "07423",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "025791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.