Provider Demographics
NPI:1700881794
Name:WILLIAMS, KERRI LICHTI (LCSW)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:LICHTI
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7103 NW SOUTH VIEW CV
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152-2443
Mailing Address - Country:US
Mailing Address - Phone:479-422-1652
Mailing Address - Fax:
Practice Address - Street 1:7103 NW SOUTH VIEW CV
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64152-2443
Practice Address - Country:US
Practice Address - Phone:479-422-1652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1730C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X152Medicare ID - Type Unspecified