Healthcare Provider Details

I. General information

NPI: 1518209741
Provider Name (Legal Business Name): CHRISTY WILLIAMS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2369 COUNTY ROAD 17
WATKINS GLEN NY
14891-9506
US

IV. Provider business mailing address

2369 COUNTY ROAD 17
WATKINS GLEN NY
14891-9506
US

V. Phone/Fax

Practice location:
  • Phone: 607-346-1132
  • Fax: 607-200-6396
Mailing address:
  • Phone: 607-346-1132
  • Fax: 607-200-6396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number402056
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number545499
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: