Doctor Name: | KIMBERLY SHEENA WILLIAMS |
NPI Number: | 1376942151 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | 180008700 |
Business Practice Address: | 55 N Arbor Trl Apt. 501 Park Forest, IL - 604662659 |
Business Phone Number: | 7084395181 |
Business Fax Number: | |
Mailing Address: | 55 N Arbor Trl, Apt. 501 PARK FOREST |
State: | IL |
Postal Code: | 604662659 |
Phone Number: | 7084395181 |
Fax Number: | |
NPI Enumeration Date: | 08/18/2014 |
NPI Last Update Date: | 01/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180008700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |