Provider Demographics
NPI:1336685122
Name:WILLIAMS, KATHERINE (LPC-MH SUPERVISEE)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC-MH SUPERVISEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 W 43RD ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-1265
Mailing Address - Country:US
Mailing Address - Phone:605-774-1243
Mailing Address - Fax:
Practice Address - Street 1:6201 W 43RD ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-1265
Practice Address - Country:US
Practice Address - Phone:605-774-1243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD20702101Y00000X
171M00000X
SD30773101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator