Jessica Williams, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

07779 Issued in OH

Practice address

1500 Eastway Drive
Kent, OH 44242-0001

Phone

(330) 672-2487

NPI assigned

Oct 18, 2018

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

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Psychological & Behavioral Consultants, LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713

  Clinical, OH

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1942776869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5190",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442420001",
            "telephone_number": "330-672-2487",
            "fax_number": "330-672-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EASTWAY DRIVE",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442420001",
            "telephone_number": "330-672-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "07779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie Wilfong
• Cynthia Wilk, APRN-CNS
• Angela Marie Wilkinson, RN
• Matthew Christian Willett, M.D.
• William U Reeves OD Inc
• Kristen H Williams, LSW, MSW, LICDC
• Michael L Williams
• Nevaeh Celeste Williams
• Remi Williams
• Tanisha S Williams

• All providers in Kent, OH
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.