Organization Active NPI

Willie. S. Williams, PH.D., LLC

  • Clinical Psychologist
  • Shaker Heights, OH
National Provider Identifier
1629102116
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
WILLIE. S. WILLIAMS, PH.D., LLC
Practice address
20310 Chagrin Blvd
Suite 2
Shaker Heights, OH 44122-4913
Phone
(216) 491-9405
Fax
(216) 491-9406
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Authorized official

Name
Willie S Williams, PH.D.
Title
Owner
Phone
(216) 491-9405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

20310 Chagrin Blvd
Suite 2
Shaker Heights, OH 44122-4913

Mailing address

20310 Chagrin Blvd
Suite 2
Shaker Heights, OH 44122-4913
Phone (216) 491-9405

National Provider Directory

National Provider Directory

Locations

20310 Chagrin Blvd
Ste 2
Shaker Heights, OH 44122
Phone (216) 491-9405

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441670400000",
    "number": "1629102116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20310 CHAGRIN BLVD",
            "address_2": "SUITE 2",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441224913",
            "telephone_number": "216-491-9405",
            "fax_number": "216-491-9406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20310 CHAGRIN BLVD",
            "address_2": "SUITE 2",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441224913",
            "telephone_number": "216-491-9405",
            "fax_number": "216-491-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIE. S. WILLIAMS, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2015-09-08",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-491-9405",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.