Provider Demographics
NPI:1366576175
Name:MCWILLIAMS, KIMBERLY CHRISTIAN (LGSW)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:CHRISTIAN
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:CHRISTIAN
Other - Last Name:SESSIONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:18201 COACHMANS RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2221
Mailing Address - Country:US
Mailing Address - Phone:210-259-7732
Mailing Address - Fax:
Practice Address - Street 1:18201 COACHMANS RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2221
Practice Address - Country:US
Practice Address - Phone:210-259-7732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171M00000X104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183068901Medicaid