Dominique Ann Williams, MA, MA, PD

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

2790832 Issued in NY

Practice address

295 Park Ave South
Apt# 17Pho
New York, NY 10010

Phone

(917) 279-1273

NPI assigned

Aug 30, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1487172482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 PARK AVE SOUTH",
            "address_2": "APT# 17PHO",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "917-279-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 PARK AVE SOUTH",
            "address_2": "APT# 17PHO",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "917-279-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DOMINIQUE",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "MA, MA, PD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "2790832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denzel Williams
• Derek JRW Williams, PA
• Desiree G Williams
• Divine Williams, LMHC
• Dominic Williams
• Donna R Williams, DDS
• Doris D. Williams, LCSW
• Duhaney Williams
• Dwayne A Williams, PA
• Edith Williams, NP

• School Psychologist in New York, NY
• Providers in New York, NY by specialty
• School Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.