Provider Demographics
NPI:1336927722
Name:WILLIAMS, KELSEY (LMHC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9093 SE SANDRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-4683
Mailing Address - Country:US
Mailing Address - Phone:772-607-4615
Mailing Address - Fax:
Practice Address - Street 1:901 SW MARTIN DOWNS BLVD STE 306&306A
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2851
Practice Address - Country:US
Practice Address - Phone:772-607-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22630101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health