Individual provider Active NPI

Kiara Mecherie Williams, LPC

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1013578202
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
78730 Issued in TX
Practice address
4455 Camp Bowie Blvd Ste 114-947
Fort Worth, TX 76107-3864
Phone
(817) 693-1814
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 78730 TX
Professional Counselor 101YP2500X 78730 TX Primary

Addresses

Primary practice location

4455 Camp Bowie Blvd Ste 114-947
Fort Worth, TX 76107-3864

Mailing address

17 Mapleridge Dr
Fort Worth, TX 76134-1300
Phone (817) 701-8111

Other identifiers 1

IdentifierTypeStateIssuer
4051500-01MedicaidTX

Other names 1

  • Kiara Mecherie Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Pieceful Therapy Counseling Services, PLLC Professional CurrentSince Dec 15, 2019 Accepting new patients

Locations

4455 Camp Bowie Blvd
Ste 114947
Fort Worth, TX 76107
Phone (817) 693-1814

5601 Bridge St
#361
Fort Worth, TX 76112
Phone (817) 492-7050

5601 Bridge St
Ste 300
Ft Worth, TX 76112
Phone (214) 945-4295

Networks

  • TX HMO
  • NM HMO C-SNP
  • TX HMO D-SNP

Interoperability endpoints

  • Direct secure messaging: kiarawilliams@tdh.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1013578202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 MAPLERIDGE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761341300",
            "telephone_number": "817-701-8111",
            "fax_number": "817-668-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 CAMP BOWIE BLVD STE 114-947",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073864",
            "telephone_number": "817-693-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KIARA",
        "middle_name": "MECHERIE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2022-04-11",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "78730",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "78730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4051500-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIARA",
            "last_name": "SMITH",
            "middle_name": "MECHERIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.