Kyle Williams, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801084481 Issued in MI

Practice address

17 N 4TH St Ste 211
Grand Haven, MI 49417-1267

Phone

(616) 402-1389

NPI assigned

Sep 16, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Gregory Kyle Williams Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychological Source, Inc.

  • Clinical Social Worker
  • Marietta, GA
  • NPI 1740421163
  NPD (past)

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1972752889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18667 PINECREST LN",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494561136",
            "telephone_number": "616-402-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 N 4TH ST STE 211",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171267",
            "telephone_number": "616-402-1389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KYLE",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-16",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801084481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "0898189",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GREGORY",
            "last_name": "WILLIAMS",
            "middle_name": "KYLE",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeremey Alan Wilder, LLPC
• Carol Ann Wilkening, CRNA
• Joel S. Wilkinson, LLMSW
• Emma Williams
• Isabella Milan Williams
• Shyra Ayn Williams, LMSW, ACTP
• Sydne Williams, PA-C
• Allen Winebarger, PHD
• Brooke Morgan Winterhalter, LMSW
• Savannah R Wirth, MA

• Clinical Social Worker in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.