Active NPI
Kathleen Williams, CHRISTIAN COUNSELOR
- Behavior Analyst
- Ellenwood, GA
National Provider Identifier
1255768735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11112378
- Practice address
- 135 Chapel Ridge Dr
Ellenwood, GA 30294-2992 - Phone
- (678) 814-5537
- NPI assigned
- Sep 30, 2013
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11112378 | GA | Primary |
Addresses
Primary practice location
135 Chapel Ridge Dr
Ellenwood, GA 30294-2992
Mailing address
135 Chapel Ridge Dr
Ellenwood, GA 30294-2992
Phone (617) 863-6224
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 |
|---|---|---|---|
| 11112378 | GA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380499200000",
"number": "1255768735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 CHAPEL RIDGE DR",
"city": "ELLENWOOD",
"state": "GA",
"postal_code": "302942992",
"telephone_number": "617-863-6224",
"fax_number": "770-389-4246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 CHAPEL RIDGE DR",
"city": "ELLENWOOD",
"state": "GA",
"postal_code": "302942992",
"telephone_number": "678-814-5537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "CHRISTIAN COUNSELOR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-30",
"last_updated": "2013-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "GA",
"license": "11112378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellenwood, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.