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General NPI Number Information
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NPI Number | 1043983224
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Entity Type | Individual
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Provider Name | KAWANA NICOLE WILLIAMS LPC
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Gender | Female
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Dates
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Enumeration Date | 07/26/2021
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 5255 N HOYNE AVE
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City | CHICAGO
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State | IL
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Zip | 60625-1227
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Country | US
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Telephone | 309-269-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 7632 S SOUTH SHORE DR APT 2C
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City | CHICAGO
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State | IL
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Zip | 60649-4426
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Country | US
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Telephone | 773-512-6083
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPP.0001632
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License Number State | CO
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