Provider Demographics
NPI:1912327925
Name:WILLIAMS, KYA (MS BCBA, LBA)
Entity type:Individual
Prefix:
First Name:KYA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E HARMONY RD UNIT A-17
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-8891
Mailing Address - Country:US
Mailing Address - Phone:470-795-0616
Mailing Address - Fax:
Practice Address - Street 1:11785 NORTHFALL LN STE 501-502
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7971
Practice Address - Country:US
Practice Address - Phone:770-569-2274
Practice Address - Fax:770-569-7432
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003195560AMedicaid