Provider Demographics
NPI:1457916231
Name:WILLIAMS, KATIE (QMHS)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:FILIPOWICZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:QMHS
Mailing Address - Street 1:625 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44702-1805
Mailing Address - Country:US
Mailing Address - Phone:330-455-0374
Mailing Address - Fax:330-453-6716
Practice Address - Street 1:601 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44702-1836
Practice Address - Country:US
Practice Address - Phone:330-455-0374
Practice Address - Fax:330-453-6716
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0347326Medicaid