Individual provider Active NPI

Cecelia L. Williams, PSY.D., MSW

  • Clinical Psychologist
  • Smyrna, GA
National Provider Identifier
1407094162
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY003254 Issued in GA
Practice address
4045 Orchard Rd SE
Suite 110
Smyrna, GA 30080-4902
Phone
(770) 293-1950
Fax
(770) 293-1955
NPI assigned
Feb 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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 PSY003254 GA Primary

Addresses

Primary practice location

4045 Orchard Rd SE
Suite 110
Smyrna, GA 30080-4902

Mailing address

4045 Orchard Rd.
Suite 110
Smyrna, GA 30080-4904
Phone (770) 293-1950

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

LicenseStateTypeSpecialty
PSY003254GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jenny Van Overbeke Brooks, PH.D., P.C. 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": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1407094162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 ORCHARD RD.",
            "address_2": "SUITE 110",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804904",
            "telephone_number": "770-293-1950",
            "fax_number": "770-293-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 ORCHARD RD SE",
            "address_2": "SUITE 110",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804902",
            "telephone_number": "770-293-1950",
            "fax_number": "770-293-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CECELIA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PSY.D., MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-03",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.