Individual provider Active NPI

Carlton Bryant Williams, PSYCHOLOGIST

  • Counseling Psychologist
  • New York, NY
National Provider Identifier
1508014135
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
017763 Issued in NY
Practice address
16 E 16TH St
New York, NY 10003-3105
Phone
(212) 206-5200
Fax
(212) 206-5279
NPI assigned
Sep 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 017763 NY Primary

Addresses

Primary practice location

16 E 16TH St
New York, NY 10003-3105

Mailing address

279 Main St
Suite 204
New Paltz, NY 12561-1623
Phone (845) 255-3046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Mar 6, 2019 through Mar 6, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
017763NYMDGeneral Acute Care Hospital

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1508014135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 MAIN ST",
            "address_2": "SUITE 204",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611623",
            "telephone_number": "845-255-3046",
            "fax_number": "845-255-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E 16TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033105",
            "telephone_number": "212-206-5200",
            "fax_number": "212-206-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CARLTON",
        "middle_name": "BRYANT",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "017763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.