Active NPI
Kathryn Williams, LPC
- Professional Counselor
- Portland, OR
National Provider Identifier
1750704771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C4072
- Practice address
- 1835 SE 50TH Ave
Portland, OR 97215-3235 - Phone
- (503) 893-4318
- NPI assigned
- Jan 27, 2014
- Last updated
- Aug 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C4072 | OR | Primary |
Addresses
Primary practice location
1835 SE 50TH Ave
Portland, OR 97215-3235
Mailing address
2605 SE 48TH Ave
Portland, OR 97206-1516
Phone (504) 893-4318
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 12, 2024 through Feb 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C4072 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596672000000",
"number": "1750704771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2605 SE 48TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972061516",
"telephone_number": "504-893-4318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1835 SE 50TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972153235",
"telephone_number": "503-893-4318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KATHRYN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-27",
"last_updated": "2020-08-06",
"certification_date": "2020-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C4072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.