Amanda D Williams

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

License

87-3238268 Issued in GA

Practice address

4691 Bluffside CT
Marietta, GA 30066-1200

Phone

(770) 885-2884

NPI assigned

Oct 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Virtue Recovery House Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cartersville, GA
  • NPI 1104563469
  NPD Authorized official

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1669136388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4691 BLUFFSIDE CT",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300661200",
            "telephone_number": "770-885-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4691 BLUFFSIDE CT",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300661200",
            "telephone_number": "770-885-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AMANDA",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "GA",
            "license": "87-3238268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87-3238268",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Nicole Williams Whitley, PH.D.
• Malya Rachelle Williams-Phillips, BT
• Alexis Rene Williams
• Alexus Lashawn Williams, RBT
• Alicia Marie Williams, MD
• Ambrea Williams
• Anthony L Williams, LSW
• Augusta Williams
• Benjamin Williams, MD
• Beverly H Williams, LPC

• Rehabilitation Psychologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Rehabilitation Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.