Active NPI
Brandon Malik Williams
- Behavior Analyst
- Eugene, OR
National Provider Identifier
1407422678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- ABA-IN-10214211
- Practice address
- 2590 Lakeview Dr Apt 4
Eugene, OR 97408-4551 - Phone
- (541) 515-0997
- NPI assigned
- May 28, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | ABA-IN-10214211 | OR | Primary |
Addresses
Primary practice location
2590 Lakeview Dr Apt 4
Eugene, OR 97408-4551
Mailing address
2590 Lakeview Dr Apt 4
Eugene, OR 97408-4551
Phone (541) 515-0997
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 |
|---|---|---|---|
| ABA-IN-10214211 | OR | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622160000000",
"number": "1407422678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2590 LAKEVIEW DR APT 4",
"city": "EUGENE",
"state": "OR",
"postal_code": "974084551",
"telephone_number": "541-515-0997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2590 LAKEVIEW DR APT 4",
"city": "EUGENE",
"state": "OR",
"postal_code": "974084551",
"telephone_number": "541-515-0997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "BRANDON",
"middle_name": "MALIK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-28",
"last_updated": "2021-05-28",
"certification_date": "2021-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "OR",
"license": "ABA-IN-10214211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.