Active NPI
Jason D Williams, PSY.D.
- Clinical Psychologist
- Little Rock, AR
National Provider Identifier
1881731685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 202267
- Practice address
- 1210 Wolfe St
Little Rock, AR 72202-4618 - Phone
- (501) 364-5150
- Fax
- (501) 364-3966
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 15944 | CA | |
| Clinical Psychologist | 103TC0700X | 3097 | CO | |
| Clinical Psychologist | 103TC0700X | 202267 | AR | Primary |
Addresses
Primary practice location
1210 Wolfe St
Little Rock, AR 72202-4618
Mailing address
PO Box 251420
Little Rock, AR 72225-1420
Phone (501) 686-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 15944 | CA | MD | Clinical Psychologist |
| 3097 | CO | MD | Clinical Psychologist |
| 202267 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1881731685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 251420",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722251420",
"telephone_number": "501-686-8000",
"fax_number": "501-526-5148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 WOLFE ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722024618",
"telephone_number": "501-364-5150",
"fax_number": "501-364-3966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JASON",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2023-02-13",
"certification_date": "2023-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 15944",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "3097",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AR",
"license": "202267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.