NPIMap

Organization Active NPI

Williamsburg Behavioral Psychology, LLC

  • Community/Behavioral Health Agency
  • Lincoln, NE
National Provider Identifier
1962762195
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
528 Issued in NE
Legal business name
WILLIAMSBURG BEHAVIORAL PSYCHOLOGY, LLC
Practice address
3801 Union Dr Ste 206
Lincoln, NE 68516-6652
Phone
(402) 489-2218
Fax
(402) 489-3666
NPI assigned
May 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Authorized official

Name
Caryll Plamer Wilson, PH.D.
Title
Psychologist
Phone
(402) 489-2218

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 528 NE Primary
Community/Behavioral Health Agency 251S00000X 766 NE
Community/Behavioral Health Agency 251S00000X 261 NE

Addresses

Primary practice location

3801 Union Dr Ste 206
Lincoln, NE 68516-6652

Mailing address

3801 Union Dr Ste 206
Lincoln, NE 68516-6652
Phone (402) 489-2218

Other identifiers 3

IdentifierTypeStateIssuer
10025286200MedicaidNE
10025107300MedicaidNE
51760228826MedicaidNE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1962762195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 UNION DR STE 206",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166652",
            "telephone_number": "402-489-2218",
            "fax_number": "402-489-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 UNION DR STE 206",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166652",
            "telephone_number": "402-489-2218",
            "fax_number": "402-489-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSBURG BEHAVIORAL PSYCHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "PLAMER WILSON",
        "authorized_official_first_name": "CARYLL",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "402-489-2218",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NE",
            "license": "528",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NE",
            "license": "766",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NE",
            "license": "261",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025286200",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025107300",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51760228826",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; 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.