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General NPI Number Information
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NPI Number | 1659892263
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Entity Type | Individual
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Provider Name | TASHARRA LAVETTE WILLIAMS MS, LPC
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Gender | Female
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 2266 N PROSPECT AVE STE 505C
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City | MILWAUKEE
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State | WI
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Zip | 53202-6319
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Country | US
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Telephone | 414-395-0468
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Fax |
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Provider Business Mailing Address
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Address Line | 2266 N PROSPECT AVE STE 505C
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City | MILWAUKEE
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State | WI
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Zip | 53202-6319
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Country | US
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Telephone | 414-395-0468
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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 | 6506-125
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License Number State | WI
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