Individual provider Active NPI

Kimberly Williams, TLLP, LLPC

  • Counseling Psychologist
  • Redford, MI
National Provider Identifier
1770357253
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6362009703 Issued in MI
Practice address
8884 Wormer
Redford, MI 48239-1230
Phone
(313) 510-6263
NPI assigned
Nov 14, 2023
Last updated
Nov 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6451022810 MI
Counseling Psychologist 103TC1900X 6362009703 MI Primary

Addresses

Primary practice location

8884 Wormer
Redford, MI 48239-1230

Mailing address

8884 Wormer
Redford, MI 48239-1230
Phone (313) 510-6263

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
6451022810MIMDProfessional Counselor
6362009703MIMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1770357253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8884 WORMER",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391230",
            "telephone_number": "313-510-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8884 WORMER",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391230",
            "telephone_number": "313-510-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KIMBERLY",
        "credential": "TLLP, LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6451022810",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6362009703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.