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: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7951 CALUMET AVE
MUNSTER IN
46321-1215
US
IV. Provider business mailing address
7951 CALUMET AVE # 1243
MUNSTER IN
46321-1215
US
V. Phone/Fax
- Phone: 708-498-3454
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 39005651A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 180011822 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: