Healthcare Provider Details

I. General information

NPI: 1023963535
Provider Name (Legal Business Name): KIMONE WILLIAMS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4332 22ND ST STE 203
LONG ISLAND CITY NY
11101-5077
US

IV. Provider business mailing address

37 BALDWIN PL APT 2
BLOOMFIELD NJ
07003-6008
US

V. Phone/Fax

Practice location:
  • Phone: 347-426-6072
  • Fax:
Mailing address:
  • Phone: 973-715-1033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number015885
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: