Provider Demographics
NPI:1932210804
Name:WILLIAMS, ROBERT C (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 COLUMBIA TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-2215
Mailing Address - Country:US
Mailing Address - Phone:518-479-4046
Mailing Address - Fax:518-479-4090
Practice Address - Street 1:726 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-2215
Practice Address - Country:US
Practice Address - Phone:518-479-4046
Practice Address - Fax:518-479-4090
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007679103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00926476Medicaid
NY150129OtherMHN
NY41134OtherMVP
NY040426032141OtherFIDELIS CARE
NY1036894OtherMETRACOMP
NY132844OtherVALUE OPTIONS; CDPHP; MHS
NY61-73007OtherUNITED BEHAVIORAL HEALTH
NY6801263003OtherGHI
NY7220089OtherAETNA
NYPSY507679-4BOtherWORKERS COMP
NY000406637003OtherBCBS; HEALTH INTEGRATED
NY41134OtherMVP