Robert Stanley Williams Jr., ED.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3105 Issued in MA

Practice address

59 Coddington St
Suite 203
Quincy, MA 02169-4510

Phone

(617) 328-4348

NPI assigned

Aug 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dearborn Wellness, LLC

  • Adult Mental Health Clinic/Center
  • Quincy, MA
  • NPI 1316398852
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417060708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 N MAIN ST",
            "city": "COHASSET",
            "state": "MA",
            "postal_code": "020251343",
            "telephone_number": "781-383-6954",
            "fax_number": "617-328-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 CODDINGTON ST",
            "address_2": "SUITE 203",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694510",
            "telephone_number": "617-328-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROBERT",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "3105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0511633",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juliana Lee Willey
• Aleah Williams
• Anthony Brandon Williams Sr.
• Christine Williams, MA
• Jennie Catherine Williams, MA
• Sharif Williams
• Stephanie E Willis
• Judith Willison, MSW, LICSW
• April Tamika Wilson
• Kayla Wilson

• Clinical Psychologist in Quincy, MA
• Providers in Quincy, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.