Individual provider Active NPI

Kristen Williams, LPC

  • Professional Counselor
  • Cartersville, GA
National Provider Identifier
1043798481
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2203003 Issued in OH
Practice address
142 Evergreen TRL
Cartersville, GA 30121-4201
Phone
(770) 655-1406
NPI assigned
Jul 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X E.2203003 OH Primary

Addresses

Primary practice location

142 Evergreen TRL
Cartersville, GA 30121-4201

Mailing address

25000 Euclid Ave Ste 305
Euclid, OH 44117-2646
Phone (216) 232-6468

Other practice location 1

1293 Copley Rd
Akron, OH 44320-2766
Phone (330) 374-1199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, TX, GA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240122003689 OH Practitioner - Mental Health Counselor 5092167403 Reassigns benefits to 2 organizations
I20240314003573 TX Practitioner - Mental Health Counselor 5092167403 Reassigns benefits to 2 organizations
I20251027004436 GA Practitioner - Mental Health Counselor 5092167403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Professional CurrentSince Jan 29, 2024 Accepting new patients
Grow Healthcare Group PA Professional CurrentSince Mar 17, 2024 Accepting new patients
Life Bridge Therapy Services LLC CurrentSince Jan 1, 2024 Accepting new patients
Washington Wellness Institute, LLC Professional Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973

5010 Mayfield Rd
Ste 210
Lyndhurst, OH 44124
Phone (216) 505-4774

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 4

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": "1532822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1043798481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25000 EUCLID AVE STE 305",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441172646",
            "telephone_number": "216-232-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 EVERGREEN TRL",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301214201",
            "telephone_number": "770-655-1406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1293 Copley Rd",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443202766",
            "country_code": "US",
            "telephone_number": "330-374-1199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KRISTEN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-29",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2203003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.