Active NPI
Kirstee Williams, PHD
- Professional Counselor
- Cleveland, TN
National Provider Identifier
1114433570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 935
- Practice address
- 1120 North Ocoee Street
Lee University
Cleveland, TN 37311 - Phone
- (423) 503-9002
- NPI assigned
- Dec 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 935 | TN | Primary |
Addresses
Primary practice location
1120 North Ocoee Street
Lee University
Cleveland, TN 37311
Mailing address
1120 North Ocoee Street
Lee University
Cleveland, TN 37311
Phone (423) 503-9002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 9, 2024 through Jan 9, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 935 | TN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee University | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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": "1513814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513814400000",
"number": "1114433570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 NORTH OCOEE STREET",
"address_2": "LEE UNIVERSITY",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "37311",
"telephone_number": "423-503-9002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 NORTH OCOEE STREET",
"address_2": "LEE UNIVERSITY",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "37311",
"telephone_number": "423-503-9002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KIRSTEE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-21",
"last_updated": "2017-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "TN",
"license": "935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.