Provider Demographics
NPI:1831459841
Name:WILLIAMS, KATHRYN KAHLE (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:KAHLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6925 REDBUD CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:IA
Mailing Address - Zip Code:50327-8700
Mailing Address - Country:US
Mailing Address - Phone:386-334-2358
Mailing Address - Fax:
Practice Address - Street 1:6925 REDBUD CT
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:IA
Practice Address - Zip Code:50327-8700
Practice Address - Country:US
Practice Address - Phone:386-334-2358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA077871101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1831459841Medicaid