Provider Demographics
NPI:1528609583
Name:WILLIAMS, KADE A (PSYD)
Entity type:Individual
Prefix:
First Name:KADE
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSY
Mailing Address - Street 1:500 MACDILL BLVD, BLDG 600
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20340
Mailing Address - Country:US
Mailing Address - Phone:567-203-7223
Mailing Address - Fax:
Practice Address - Street 1:500 MACDILL BLVD, BLDG 600
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20340
Practice Address - Country:US
Practice Address - Phone:567-203-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA8010006213103TC0700X
VA0810006213103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0810006213OtherTRICARE
VA0810006213OtherTRICARE