Individual
MR. KEVIN JAMES WILLIAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCC-S
Contact information
Practice address
3500 CARNEGIE AVE, CLEVELAND, OH 44115-2641
(440) 260-8436
(440) 260-8576
Mailing address
3500 CARNEGIE AVE, CLEVELAND, OH 44115-2641
(440) 260-8436
(440) 260-8576
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701002759
VA
101YM0800X
Mental Health Counselor
Primary
E.0008231-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010082765
—
VA
05
—
010082862
—
VA
01
—
023469000
MAGELLAN
VA
01
—
334392
TRIGON PPU
—
01
—
334393
TRIGON PPU
—
01
—
334394
TRIGON PPU
—
Enumeration date
01/04/2006
Last updated
01/13/2012
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