Joanne Marie Williamsen, LP

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

LP3939 Issued in MN

Practice address

3300 County Road 10
Suite 500
Brooklyn Center, MN 55429-3072

Phone

(763) 560-8331

Fax

(763) 560-8431

NPI assigned

Feb 19, 2007

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)

Enrolled

Credentials

Master of Arts

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.

• Advanced Behavioral Health, Inc

  • Adult Mental Health Clinic/Center
  • Brooklyn Center, MN
  • NPI 1013139419
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1831233055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 COUNTY ROAD 10",
            "address_2": "SUITE 500",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554293072",
            "telephone_number": "763-560-8331",
            "fax_number": "763-560-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 COUNTY ROAD 10",
            "address_2": "SUITE 500",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554293072",
            "telephone_number": "763-560-8331",
            "fax_number": "763-560-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSEN",
        "first_name": "JOANNE",
        "middle_name": "MARIE",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MN",
            "license": "LP3939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "436321300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Wiederhold
• Melanie Ann Wigen
• Alexis Renee Williams
• Jordan David Williams
• Qunnitina Williams
• Trista Willis
• Ashly Wilson, OTR/L
• Celia JM Wilson
• Gabriella Grace Winter
• Liam Witte

• Intellectual & Developmental Disabilities Psychologist in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Intellectual & Developmental Disabilities Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.