Active NPI
Keren Happuch Williams, LCMHC
- Mental Health Counselor
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10911
- Practice address
- 140 Kimel Park Dr Ste 200
Winston Salem, NC 27103-6185 - Phone
- (336) 718-7250
- Fax
- (336) 718-7260
- NPI assigned
- Aug 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 10911 | NC | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20281 | NC | |
| Mental Health Counselor | 101YM0800X | 10911 | NC | Primary |
Addresses
Primary practice location
140 Kimel Park Dr Ste 200
Winston Salem, NC 27103-6185
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Other practice location 1
820 Grimes Blvd
Lexington, NC 27292-7640
Phone (866) 272-7826
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13815 Professional Ctr Dr
Suite 300
Huntersville, NC 28078-7950
Phone (704) 384-6225
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20281 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Forsyth Memorial Hospital, Inc. | Current | Accepting new patients | |
| Forsyth Memorial Hospital, Inc. | Current | Accepting new patients | |
| Forsyth Memorial Hospital, Inc. | Current | Accepting new patients |
Locations
6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473
13815 Professional Center Dr
Ste 100
Huntersville, NC 28078
Phone (704) 316-2050
13815 Professional Center Dr
#300
Huntersville, NC 28078
Phone (704) 384-6225
280 Broad St
Ste E
Kernersville, NC 27284
Phone (336) 277-6050
6620 Shallowford Rd
#200
Lewisville, NC 27023
Phone (336) 757-0258
309 Pineywood Rd
Thomasville, NC 27360
Phone (336) 474-8921
140 Kimel Park Dr
Ste 101
Winston Salem, NC 27103
Phone (336) 718-7280
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
175 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 277-1811
140 Kimel Park Dr
Ste 200
Winston Salem, NC 27103
Phone (336) 718-7250
Networks
- devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1
- devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
- devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
- TN PPO
- TN PPO C-SNP
Interoperability endpoints
- kwilliams1303634@direct.novanthealth.org
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- NPI 1366409492
-
- Family Medicine Physician
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- NPI 1104548874
-
- Psychiatry Physician
- Winston Salem, NC
- NPI 1194447805
-
- Cardiovascular Disease Physician
- Winston Salem, NC
- NPI 1932935475
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Psychiatry Physician
- Huntersville, NC
- NPI 1588387211
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706745600000",
"number": "1003163213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 KIMEL PARK DR STE 200",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036185",
"telephone_number": "336-718-7250",
"fax_number": "336-718-7260"
}
],
"practiceLocations": [
{
"address_1": "820 Grimes Blvd",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "NC",
"postal_code": "272927640",
"country_code": "US",
"telephone_number": "866-272-7826",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KEREN",
"middle_name": "HAPPUCH",
"credential": "LCMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-07",
"last_updated": "2024-02-01",
"certification_date": "2024-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "10911",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "20281",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "10911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.