Kelley Willis, MSW

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

14900 Bogle Dr
Suite 200
Chantilly, VA 20151-1756

Phone

(703) 817-9890

Fax

(703) 817-9860

NPI assigned

Jun 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1790135549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14900 BOGLE DR",
            "address_2": "SUITE 200",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511756",
            "telephone_number": "703-817-9890",
            "fax_number": "703-817-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14900 BOGLE DR",
            "address_2": "SUITE 200",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511756",
            "telephone_number": "703-817-9890",
            "fax_number": "703-817-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KELLEY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Telina Marie Williams-Stuckey, D.O.
• Albert Wayne Williams, M.D.
• Brittney Williams, CPM, LM
• Frances Darlene Williams, LPC
• Jacob Williams
• Cassandra Wilson
• Coen Wilson
• Lauren Grace Wilson
• Mena Wilson
• Melissa Winchell, NP-C

• Counselor in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.