Provider Demographics
NPI:1942767520
Name:WILLIAMS, KRISTEN H (LSW, MSW, LICDC)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:H
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LSW, MSW, LICDC
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:H
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:2390 ROTH DR
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3026
Mailing Address - Country:US
Mailing Address - Phone:330-701-3786
Mailing Address - Fax:
Practice Address - Street 1:87 CONSERVATORY DR
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-4291
Practice Address - Country:US
Practice Address - Phone:234-334-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-01
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2004929104100000X
OHLICDC.162490101YA0400X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0405812Medicaid