Healthcare Provider Details

I. General information

NPI: 1659252112
Provider Name (Legal Business Name): KAILEY WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 10/24/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10605 CONCORD ST STE 206
KENSINGTON MD
20895-2526
US

IV. Provider business mailing address

10605 CONCORD ST STE 206
KENSINGTON MD
20895-2526
US

V. Phone/Fax

Practice location:
  • Phone: 301-861-2248
  • Fax:
Mailing address:
  • Phone: 301-861-2248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: