Kellyne Williams, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P019495 Issued in NC

Practice address

1006 Houndscroft Rd
Indian Trail, NC 28079-8814

Phone

(704) 231-4402

NPI assigned

Aug 7, 2023

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

Locations

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.

• Ubuntu Holistic Counseling & Consulting PLLC

  • Mental Health Counselor
  • Indian Trail, NC
  • NPI 1659005841
  NPD

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1679255863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 SARDIS RD N STE 207",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282703000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 HOUNDSCROFT RD",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280798814",
            "telephone_number": "704-231-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KELLYNE",
        "credential": "LCSW-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P019495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Porter Weber, OTD, OTR/L
• Ian Wilds
• Margaret Wilkoff, M.S., CCC-SLP
• Christine E Williams, PHARMD
• Jonathan P Williams, LCMHC
• Joshua Wilson, PA
• Marlo Lewis Wilson, LPC, LCMHC
• Terilyn Wilson, OTR/L
• Ashley Michele Wiltcher, AGPCNP-BC
• Nia Wiltz

• Clinical Social Worker in Indian Trail, NC
• Providers in Indian Trail, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.