Micheal Williams Jr., MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP 21091 Issued in CA

Practice address

15928 Ventura Blvd Ste 218
Encino, CA 91436-4413

Phone

(818) 518-9709

Fax

(747) 230-8320

NPI assigned

Apr 26, 2016

Last updated

Jan 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

Enrollment records 2

Specialty

Qualified Speech Language Pathologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Williams Speech Therapy Services IncGroup PAC ID 5698067957, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Williams Speech Therapy Services Inc.

  dba Williams Therapy Services, Inc

  • Speech-Language Pathologist
  • San Antonio, TX
  • NPI 1740637834

  CA

  Medicare reassignment Care Compare group Authorized official
• Novum Therapy Partners, Inc.

  • Speech-Language Pathologist
  • San Antonio, TX
  • NPI 1194588111
  NPD Authorized official

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1417302605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15928 VENTURA BLVD STE 218",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364413",
            "telephone_number": "818-518-9709",
            "fax_number": "747-230-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15928 VENTURA BLVD STE 218",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364413",
            "telephone_number": "818-518-9709",
            "fax_number": "747-230-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MICHEAL",
        "name_suffix": "Jr.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 21091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brie M Williams
• Carolyn Lee Williams, PHD
• Chad Williams
• Erika Datuin Williams, OTR/L
• Kila Williams
• Nakia Shavan Williams
• Nashia Williams
• Richard Allen Williams, M.D.
• Judith Kristie Williamson, RN NP
• Ann Willis

• Speech-Language Pathologist in Encino, CA
• Providers in Encino, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.