Mary Todd Williamson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY01775 Issued in MO

Practice address

3217 S Providence Rd
Columbia, MO 65203-3639

Phone

(573) 884-7733

Fax

(573) 884-5559

NPI assigned

May 18, 2006

Last updated

Sep 25, 2008By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1821041021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7687",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652057687",
            "telephone_number": "573-882-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 S PROVIDENCE RD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652033639",
            "telephone_number": "573-884-7733",
            "fax_number": "573-884-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "MARY",
        "middle_name": "TODD",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "PY01775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498143601",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "680007308",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00415787",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terence Terrell Williams
• Zakiyah Lea Williams
• Zion Williams
• Ethan Williamson, MD
• Harold A Williamson, MD
• Hope Madison Williard, PA-C
• Zachary Williard
• Dale Willis, M.A.
• Lia Willis, PH.D.
• Phyllis Ann Willis, CRNA

• Clinical Psychologist in Columbia, MO
• Providers in Columbia, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.