Kirstie Williams

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2024040150 Issued in MO

Practice address

1735 Cherry Blossom CT
Pevely, MO 63070-1347

Phone

(618) 954-9167

NPI assigned

Mar 28, 2024

Last updated

Oct 26, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Agape Christian Counseling Services

  • Professional Counselor
  • Saint Louis, MO
  • NPI 1407906803
  NPD (past)

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729900800000",
    "number": "1598516528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 CHERRY BLOSSOM CT",
            "city": "PEVELY",
            "state": "MO",
            "postal_code": "630701347",
            "telephone_number": "618-954-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 CHERRY BLOSSOM CT",
            "city": "PEVELY",
            "state": "MO",
            "postal_code": "630701347",
            "telephone_number": "618-954-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KIRSTIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-10-26",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2024040150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Lynn Viehman, PHARMD
• Jodi M. Walker, MA
• Jason Alexander Wang, PHARM.D.
• Warm Light Counseling, L.L.C.
• Gina Louise Whitener, COTA/L

• Clinical Social Worker in Pevely, MO
• Providers in Pevely, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2024; 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.