Judith L Williams, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042458A Issued in IN

Practice address

2355 E Cedar Canyons Rd
Fort Wayne, IN 46845-9330

Phone

(260) 925-2017

Fax

(260) 925-9713

NPI assigned

Nov 17, 2005

Last updated

Sep 1, 2021By 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 2

Addresses

Electronic endpoints 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

State licenses

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.

• Family Counseling Center, LLC

  • Clinical Psychologist
  • Fort Wayne, IN
  • NPI 1730480211
  Authorized official Same address or phone
• James P. Spink

  dba Family Counseling Center

  • Psychologist
  • Auburn, IN
  • NPI 1932246972

  Clinical

  NPD (past)

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1508848391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 289",
            "city": "EDGERTON",
            "state": "OH",
            "postal_code": "435170289",
            "telephone_number": "260-925-2017",
            "fax_number": "260-925-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 E CEDAR CANYONS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459330",
            "telephone_number": "260-925-2017",
            "fax_number": "260-925-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JUDITH",
        "middle_name": "L",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39000462",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042458A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@familycounselingcenterllc.com",
            "affiliation": "N",
            "address_1": "2355 E Cedar Canyons Rd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468459330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Felicia M Williams, LSW
• Jeffrey S. Williams, PA-C
• Jennifer Michele Williams, DC
• John I Williams, MD
• Juan Deon Williams
• Keegan Williams
• Kishyla Williams
• Kyra Williams
• Logan Alan Williams, CRNA
• Mackenzie Linn Williams, ATC, LAT

• Clinical Psychologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.