Susan C. Williams, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY5815 Issued in FL

Practice address

2107 Hendricks Ave Ste 2
Jacksonville, FL 32207-3370

Phone

(904) 716-0757

Fax

(904) 425-0028

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Susan C Williams,PHD,PA

  • Psychologist
  • Jacksonville, FL
  • NPI 1780971671
  NPD Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673654400000",
    "number": "1780604736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043811",
            "telephone_number": "904-716-0757",
            "fax_number": "904-425-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 HENDRICKS AVE STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073370",
            "telephone_number": "904-716-0757",
            "fax_number": "904-425-0028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12058 San Jose Blvd Ste 602",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322238668",
            "country_code": "US",
            "telephone_number": "904-716-0757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SUSAN",
        "middle_name": "C.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2023-01-14",
        "certification_date": "2023-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shayla Williams
• Sherrill Williams, DPT
• Skyler Tyne Williams, M.S.
• Sonya Williams, CNA
• Stacy Lynn Williams, ARNP
• Takita Williams, ED.S, M.S.ED
• Tamara Williams, LMHC
• Tami Williams, DNAP, CRNA
• Tangela Williams
• Tanitha Williams

• Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2023; 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.