Individual provider Active NPI

Mary Kilkenny Williams, MFT

  • Marriage & Family Therapist
  • Manchester, CA
National Provider Identifier
1740475987
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT22544 Issued in CA
Practice address
40400 Mt View Rd
Manchester, CA 95459
Phone
(707) 882-2477
Fax
(702) 882-2477
NPI assigned
Sep 11, 2007
Last updated
Sep 11, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT22544 CA Primary

Addresses

Primary practice location

40400 Mt View Rd
Manchester, CA 95459

Mailing address

PO Box 343
Point Arena, CA 95468-0343
Phone (707) 882-2477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFT22544CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1740475987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 343",
            "city": "POINT ARENA",
            "state": "CA",
            "postal_code": "954680343",
            "telephone_number": "707-882-2477",
            "fax_number": "707-882-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40400 MT VIEW RD",
            "city": "MANCHESTER",
            "state": "CA",
            "postal_code": "95459",
            "telephone_number": "707-882-2477",
            "fax_number": "702-882-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARY",
        "middle_name": "KILKENNY",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT22544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.