Provider Demographics
NPI:1255444188
Name:WILLIAMS THOMAS, JOYCELYN SHERI (PHD)
Entity type:Individual
Prefix:DR
First Name:JOYCELYN
Middle Name:SHERI
Last Name:WILLIAMS THOMAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JOYCELYN
Other - Middle Name:SHERI
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2336 S MOBBERLY AVE # 7153
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75602-3864
Mailing Address - Country:US
Mailing Address - Phone:817-607-3868
Mailing Address - Fax:855-541-0383
Practice Address - Street 1:2336 S MOBBERLY AVE # 7153
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75602-3864
Practice Address - Country:US
Practice Address - Phone:817-607-3868
Practice Address - Fax:855-541-0383
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36150103T00000X, 103TC1900X, 103TF0200X, 103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11829119OtherCAQH
TX160714504Medicaid
TX6634LCOtherBCBS PROVIDER
TX1607145-02Medicaid