Kenyatta Nichole Williams-Ross, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149019450 Issued in IL

Practice address

355 Ridge Ave
Evanston, IL 60202-3328

Phone

(847) 316-2440

NPI assigned

Aug 2, 2017

Last updated

Aug 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kenyatta Nichole Williams-Ross Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Gifted Soul, LLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1255094983
  NPD Authorized official
• Journey's Community Center Inc.

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1427427376

  Clinical

  NPD (past)

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1538683396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 W JEROME ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451231",
            "telephone_number": "630-701-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023328",
            "telephone_number": "847-316-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS-ROSS",
        "first_name": "KENYATTA",
        "middle_name": "NICHOLE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENYATTA",
            "last_name": "WILLIAMS-ROSS",
            "middle_name": "NICHOLE",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Douglas Alan Willaman, PA-C
• Nancy Willard, PHYSICAL THERAPIST
• Amelia Willcox
• Gabrielle R Willey, PSY.D.
• Kaitlin Ann Willham, M.D.
• Alexandria Williams, MD
• Andrew Easton Williams, MD
• Aser L Williams, LCSW
• Deja Labelle Williams
• Elizabeth Williams, MA

• Clinical Social Worker in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.