Individual provider Active NPI

Stephanie L Williams, M.A., M.S., M.ED.

  • Specialist
  • Roosevelt, NY
National Provider Identifier
1578818001
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
6 Bainbride Street
Roosevelt, NY 11575-0040
Phone
(516) 379-4904
NPI assigned
Jul 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NY Primary

Addresses

Primary practice location

6 Bainbride Street
Roosevelt, NY 11575-0040

Mailing address

6 Bainbridge St
P.O. Box 40
Roosevelt, NY 11575-2403
Phone (516) 379-4904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts, Master of Education, Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1578818001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BAINBRIDGE ST",
            "address_2": "P.O. BOX 40",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115752403",
            "telephone_number": "516-379-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BAINBRIDE STREET",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115750040",
            "telephone_number": "516-379-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "M.A., M.S., M.ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, NY

Sources for this page

  • 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.