MEDICARE: MR. BARRETT WILLIAMS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	1466	OK
2	103TH0100X	Health Service Psychologist	1466	OK

General Provider Information

NPI Number	:	1154474054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BARRETT WILLIAMS PHD

Provider Business Mailing Address
First Line	:	5310 E 31ST ST STE 13
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-5013
Country	:	US
Telephone Number	:	918-561-5701
Fax Number	:	918-561-1173

Provider Business Practice Location Address
First Line	:	5310 E 31ST ST STE 13
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-5013
Country	:	US
Telephone Number	:	918-236-4000
Fax Number	:	918-236-4001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	09/25/2024

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