Healthcare Provider Details

I. General information

NPI: 1376007344
Provider Name (Legal Business Name): JASMINE L. WILLIAMS LCPC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2019
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 E LAKE ST STE 1300
CHICAGO IL
60601-7458
US

IV. Provider business mailing address

9750 CRESCENT PARK CIR
ORLAND PARK IL
60462-7540
US

V. Phone/Fax

Practice location:
  • Phone: 312-726-4011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39005651A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180011822
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: