Active NPI
Kenneth Bryan Williams, LCMHCA
- Mental Health Counselor
- Burlington, NC
National Provider Identifier
1205501632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A16870
- Practice address
- 2207 Delaney Dr Ste 201
Burlington, NC 27215-5263 - Phone
- (336) 264-2420
- NPI assigned
- Aug 9, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A16870 | NC | Primary |
Addresses
Primary practice location
2207 Delaney Dr Ste 201
Burlington, NC 27215-5263
Mailing address
2207 Delaney Dr Ste 201
Burlington, NC 27215-5263
Phone (336) 264-2420
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A16870 | Other | NC | LCMHC LICSENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A16870 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628467200000",
"number": "1205501632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2207 DELANEY DR STE 201",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272155263",
"telephone_number": "336-264-2420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2207 DELANEY DR STE 201",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272155263",
"telephone_number": "336-264-2420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KENNETH",
"middle_name": "BRYAN",
"name_prefix": "Mr.",
"credential": "LCMHCA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-09",
"last_updated": "2021-08-09",
"certification_date": "2021-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A16870",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCMHC LICSENSE",
"identifier": "A16870",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.