MEDICARE: KERRI LICHTI WILLIAMS LCSW

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
1	1041C0700X	Clinical Social Worker	1730C	AR

General Provider Information

NPI Number	:	1700881794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRI LICHTI WILLIAMS LCSW

Provider Business Mailing Address
First Line	:	7103 NW SOUTH VIEW CV
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64152-2443
Country	:	US
Telephone Number	:	479-422-1652
Fax Number	:

Provider Business Practice Location Address
First Line	:	7103 NW SOUTH VIEW CV
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64152-2443
Country	:	US
Telephone Number	:	479-422-1652
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	10/12/2012

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