Provider Demographics
NPI:1356840375
Name:WILLIAMS, KACI LYNN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KACI
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KACI
Other - Middle Name:LYNN
Other - Last Name:BALLWEG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:26 SCHROEDER CT STE 210
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2503
Mailing Address - Country:US
Mailing Address - Phone:608-270-2511
Mailing Address - Fax:608-270-2511
Practice Address - Street 1:26 SCHROEDER CT STE 210
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2503
Practice Address - Country:US
Practice Address - Phone:608-270-2511
Practice Address - Fax:608-270-0467
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI584-228106H00000X
WI1353-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist