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NPI Code Detail

MEDICARE: KAISHA WILLIAMS LPC

MEDICARE: KAISHA 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 Counselor0701009201VA

General Provider Information

NPI Number : 1669095410
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAISHA WILLIAMS LPC
Provider Business Mailing Address
First Line : 3005 PETERS CREEK RD NW
Second Line :
City : ROANOKE
State : VA
Zip : 24019-2738
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3005 PETERS CREEK RD NW
Second Line :
City : ROANOKE
State : VA
Zip : 24019-2738
Country : US
Telephone Number : 540-400-1192
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2020
Last Update Date : 02/17/2021

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Directions to “ KAISHA WILLIAMS LPC” Practice Location

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