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NPI Code Detail

MEDICARE: KIA WILLIAMS LPC

MEDICARE: KIA WILLIAMS LPC
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
1101YP2500XProfessional Counselor0004886CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10004886OTHERCOCOLORADO DEPARTMENT OF REGULATORY AGENCIES

General Provider Information

NPI Number : 1154833465
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIA WILLIAMS LPC
Provider Business Mailing Address
First Line : 1795 JET WING DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80916-2332
Country : US
Telephone Number : 719-572-6111
Fax Number :
Provider Business Practice Location Address
First Line : 1795 JET WING DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80916-2332
Country : US
Telephone Number : 719-572-6111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2017
Last Update Date : 03/15/2026

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