Gerard R. Williams, PHD LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301007038 Issued in MI

Practice address

1309 S. Linden Rd.
Suite C
Flint, MI 48532

Phone

(810) 630-1152

Fax

(810) 630-9107

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Delta Family Clinic South P.C

  • Adult Mental Health Clinic/Center
  • Flint, MI
  • NPI 1255509832
  Medicare reassignment NPD Authorized official
• Delta Family Clinic South PC

  • Clinical Psychologist
  • Bay City, MI
  • NPI 1902162746
  NPD (past) Authorized official
• Delta Family Clinic South P.C

  • Adult Mental Health Clinic/Center
  • Flint, MI
  • NPI 1114768884

  Psychologist

  NPD (past)
• Twin Oaks Mental Health Center, LLC

  • Adult Mental Health Clinic/Center
  • Petoskey, MI
  • NPI 1912390741
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1821158817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 S. LINDEN RD",
            "address_2": "SUITE C",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48532",
            "telephone_number": "810-630-1152",
            "fax_number": "810-630-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 S. LINDEN RD.",
            "address_2": "SUITE C",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48532",
            "telephone_number": "810-630-1152",
            "fax_number": "810-630-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "GERARD",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PHD LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301007038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OPC",
            "identifier": "750910736",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0B51092",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Diane Williams
• Demya Williams
• Deosha Williams, NURSE PRACITIONER
• Dwone Demetrius Williams
• Ean Williams
• Gesheika Jenee Williams, LLBSW
• Jacob Williams, MPH
• Jordan Williams, PRC
• Kadaya Williams
• Kelsey Williams

• Psychologist in Flint, MI
• Providers in Flint, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.