NPIMap

Individual provider Active NPI

Daniel Jacob Williams, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Morristown, TN
National Provider Identifier
1740386879
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
2951 Issued in TN
Practice address
836 W 1St North St
Morristown, TN 37814-4548
Phone
(423) 581-5342
Fax
(423) 581-8650
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 8856 MA
Clinical Psychologist 103TC0700X 8856 MA
Clinical Psychologist 103TC0700X 2951 TN
Clinical Child & Adolescent Psychologist 103TC2200X 2951 TN Primary

Addresses

Primary practice location

836 W 1St North St
Morristown, TN 37814-4548

Mailing address

PO Box 1678
Morristown, TN 37816-1678
Phone (423) 581-5342

Other identifiers 1

IdentifierTypeStateIssuer
1031681278OtherMEDICARE PTAN

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2951TNMDOccupational Therapy Assistant
8856MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hopenation Counseling, Inc. Current Accepting new patients
Crossroads Integrated Health Services, Inc. Clinical Past Accepting new patients
Lifecare Family Services Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1740386879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1678",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378161678",
            "telephone_number": "423-581-5342",
            "fax_number": "423-581-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W 1ST NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378144548",
            "telephone_number": "423-581-5342",
            "fax_number": "423-581-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DANIEL",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "8856",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8856",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "2951",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TN",
            "license": "2951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "1031681278",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; 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.