Kaitlin Alyse Williams, RADT-1
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Camino, CA
NPI 1750004099 · NPPES record last updated Sep 21, 2022
Key facts
- NPI
- 1750004099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- R1483900922 (CA)
- Practice address
- 5494 Pony Express TRL
Camino, CA 95709-9403 - Phone
- (530) 644-3758
- NPI assigned
- Sep 21, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1483900922 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Progress House, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1483900922 | CA | Yes |
Addresses
Primary practice location
5494 Pony Express TRL
Camino, CA 95709-9403
Mailing address
PO Box 586
Camino, CA 95709-0586
Other providers in Camino, CA
- Thomas Howard Shewmake
- Christina Smith
- Ashley Stetler
- Rhea Swisher
- Ellen Louise Turner
- Amanda Marie Woods
All providers in Camino, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.