Individual provider Active NPI

Katrina Bess Williams, LPC

  • Mental Health Counselor
  • Canton, OH
National Provider Identifier
1700366275
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.2103369 Issued in OH
Practice address
601 Cleveland Ave NW
Canton, OH 44702-1836
Phone
(330) 455-0374
Fax
(330) 453-6716
NPI assigned
Aug 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.2103369 OH Primary

Addresses

Primary practice location

601 Cleveland Ave NW
Canton, OH 44702-1836

Mailing address

625 Cleveland Ave NW
Canton, OH 44702-1805
Phone (330) 455-0374

Other practice location 1

1341 Market Ave N
Canton, OH 44714-2605
Phone (304) 538-2523

Other identifiers 1

IdentifierTypeStateIssuer
0403713MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240104004323 OH Practitioner - Mental Health Counselor 5799136636 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.2103369OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Commquest Services, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Commquest Services, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

601 Cleveland Ave NW
Canton, OH 44702
Phone (330) 453-8252

625 Cleveland Ave NW
Canton, OH 44702
Phone (330) 445-2677

1341 Market Ave N
Canton, OH 44714
Phone (330) 453-8252

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1700366275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "330-455-0374",
            "fax_number": "330-453-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021836",
            "telephone_number": "330-455-0374",
            "fax_number": "330-453-6716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1341 Market Ave N",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447142605",
            "country_code": "US",
            "telephone_number": "304-538-2523",
            "fax_number": "330-452-4655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KATRINA",
        "middle_name": "BESS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2103369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0403713",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.