Myrna B. Williams, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0953 Issued in NC

Practice address

1530 Martin St
Suite 203
Winston Salem, NC 27103-4936

Phone

(336) 748-9114

Fax

(336) 748-1040

NPI assigned

Jul 21, 2007

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

Other identifiers 2

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": "1184976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184976000000",
    "number": "1871793497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5052",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271135052",
            "telephone_number": "336-748-9114",
            "fax_number": "336-748-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 MARTIN ST",
            "address_2": "SUITE 203",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034936",
            "telephone_number": "336-748-9114",
            "fax_number": "336-748-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MYRNA",
        "middle_name": "B.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-21",
        "last_updated": "2007-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "0953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "03764",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000153",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mathew Wade Williams, PA-C
• Melissa Williams, PTA
• Meredith M. Williams, PA
• Michael Williams
• Monica Williams, LPC
• Natashi Maria Williams
• Robert L. Williams, MD
• Sarah Thomas Williams, NP-C
• Sha-Lai L Williams, MSW, LCSW
• Shadae T Williams

• Clinical Psychologist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2007; 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.