Provider Demographics
NPI:1659252112
Name:WILLIAMS, KAILEY
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10605 CONCORD ST STE 206
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2526
Mailing Address - Country:US
Mailing Address - Phone:301-861-2248
Mailing Address - Fax:
Practice Address - Street 1:10605 CONCORD ST STE 206
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2526
Practice Address - Country:US
Practice Address - Phone:301-861-2248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101YM0800X, 221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health