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General NPI Number Information
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NPI Number | 1013578202
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Entity Type | Individual
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Provider Name | KIARA MECHERIE WILLIAMS LPC
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Gender | Female
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Dates
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Enumeration Date | 06/27/2019
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 4455 CAMP BOWIE BLVD STE 114-947
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City | FORT WORTH
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State | TX
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Zip | 76107-3864
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Country | US
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Telephone | 817-693-1814
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Fax |
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Provider Business Mailing Address
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Address Line | 17 MAPLERIDGE DR
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City | FORT WORTH
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State | TX
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Zip | 76134-1300
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Country | US
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Telephone | 817-701-8111
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Fax | 817-668-6629
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 78730
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 78730
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License Number State | TX
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