Provider Demographics
NPI:1417168014
Name:WILLIAMS, KEVIN ARTHER (PLMHP)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:ARTHER
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3721 N 75TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-4411
Mailing Address - Country:US
Mailing Address - Phone:402-201-6963
Mailing Address - Fax:
Practice Address - Street 1:3721 N 75TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-4411
Practice Address - Country:US
Practice Address - Phone:402-201-6963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7689101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health