Active NPI
Thomas Joseph Williams, PH.D.
- Clinical Psychologist
- Ft. Meade, MD
National Provider Identifier
1609918887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35-586
- Practice address
- 2480 Llewellyn Ave
Kimbrough Ambulatory Care Center
Ft. Meade, MD 20755 - Phone
- (717) 245-4511
- Fax
- (717) 245-4558
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35-586 | MS | Primary |
Addresses
Primary practice location
2480 Llewellyn Ave
Kimbrough Ambulatory Care Center
Ft. Meade, MD 20755
Mailing address
2480 Llewellyn Ave
Kimbrough Ambulatory Care Center
Ft. Meade, MD 20755
Phone (717) 245-4511
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-586 | MS | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609918887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2480 LLEWELLYN AVE",
"address_2": "KIMBROUGH AMBULATORY CARE CENTER",
"city": "FT. MEADE",
"state": "MD",
"postal_code": "20755",
"telephone_number": "717-245-4511",
"fax_number": "717-245-4558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2480 LLEWELLYN AVE",
"address_2": "KIMBROUGH AMBULATORY CARE CENTER",
"city": "FT. MEADE",
"state": "MD",
"postal_code": "20755",
"telephone_number": "717-245-4511",
"fax_number": "717-245-4558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "THOMAS",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MS",
"license": "35-586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft. Meade, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.