Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Georgia Kelly-Williams

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1104545037

Georgia Kelly-Williams is a Nurse Practitioner in Deer Park, New York. Qualified in 2022, 4 years ago. Practices with Cs Medical Associates, PC, a 63-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022

Practice location Address checks out

52 Tiber Ave
Deer Park, NY 11729-7012
Phone: (631) 404-8843
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 404380 (NY)

Record details

NPI number1104545037
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 24, 2022
Last updated in NPPESAugust 24, 2022
Certification dateAugust 24, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Cs Medical Associates, Pc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Deer Park