MEDICARE: KAYLA WILLIAMS

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1902502016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA WILLIAMS

Provider Business Mailing Address
First Line	:	3249 ARROWHEAD CIR APT G
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-7360
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5641 BURKE CENTRE PKWY STE 206
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-2259
Country	:	US
Telephone Number	:	301-392-7908
Fax Number	:

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

Provider Enumeration Date	:	02/01/2023
Last Update Date	:	03/18/2025

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