Active NPI
Kandace Ranae' Williams
- Behavior Technician
- Plymouth, MI
National Provider Identifier
1184261554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 650 Church St Ste 215
Plymouth, MI 48170-1689 - Phone
- (734) 926-9323
- NPI assigned
- Dec 4, 2019
- Last updated
- Oct 15, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
650 Church St Ste 215
Plymouth, MI 48170-1689
Mailing address
48571 S Interstate 94 Service Dr Apt 108
Van Buren TWP, MI 48111-1747
Phone (616) 617-2859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1184261554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48571 S INTERSTATE 94 SERVICE DR APT 108",
"city": "VAN BUREN TWP",
"state": "MI",
"postal_code": "481111747",
"telephone_number": "616-617-2859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 CHURCH ST STE 215",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481701689",
"telephone_number": "734-926-9323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KANDACE",
"middle_name": "RANAE'",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-04",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.