MEDICARE: KIMBERLY S WILLIAMS LPC, NCC

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	1041C0700X	Clinical Social Worker	2998B	AL
2	101YP2500X	Professional Counselor	C2218A	AL
3	101YM0800X	Mental Health Counselor	3646	AL

General Provider Information

NPI Number	:	1487899522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY S WILLIAMS LPC, NCC

Provider Business Mailing Address
First Line	:	4268 CAHABA HEIGHTS CT
Second Line	:	SUITE 166
City	:	VESTAVIA
State	:	AL
Zip	:	35243-5711
Country	:	US
Telephone Number	:	205-586-5964
Fax Number	:

Provider Business Practice Location Address
First Line	:	4268 CAHABA HEIGHTS CT
Second Line	:	SUITE 166
City	:	VESTAVIA
State	:	AL
Zip	:	35243-5711
Country	:	US
Telephone Number	:	205-586-5964
Fax Number	:

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

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	04/25/2017

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