Ethan Scott Williamson
Behavior Technician in Gulfport, MS. Individual provider (NPI-1).
NPI number1649023946
StatusActive
Last updated in NPPESAug 4, 2025
Details
- NPI
- 1649023946
- Entity type
- Individual (NPI-1)
- Name
- Mr. Ethan Scott Williamson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 8, 2024
- Certification date
- Aug 4, 2025
- Last updated
- Aug 4, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
708 Broad AveGulfport, MS 39501-1350
Phone 731-614-3101
Mailing address
43 Central Church RdPurvis, MS 39475-3609
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 224 Behavior Technician providers in Gulfport · All 2,821 providers in Gulfport
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