Kameshia S Willis, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

19-82907 Issued in FL

Practice address

145 E Edgewood Dr
Lakeland, FL 33803-4014

Phone

(863) 777-0134

Fax

(864) 644-9590

NPI assigned

Mar 16, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Applied Behavioral Learning Experiences, Inc

  • Community/Behavioral Health Agency
  • Lakeland, FL
  • NPI 1760627905
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1407397979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E EDGEWOOD DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034014",
            "telephone_number": "863-777-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E EDGEWOOD DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034014",
            "telephone_number": "863-777-0134",
            "fax_number": "864-644-9590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1116 Nikki View Dr",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335114868",
            "country_code": "US",
            "telephone_number": "855-832-6727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KAMESHIA",
        "middle_name": "S",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "19-82907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "247200000X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shantee Williams
• Shavonda Williams
• Uriah Jordan Williams Sr.
• Wanda Williams, OT
• Yalunda Williams
• Taccara Willis
• Morgan Willoughby, PA-C
• Willows Path Counseling
• Elizabeth Wills
• Teresa L Wilmoth, ARNP

• Behavior Technician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.