MEDICARE: LEKEISHA LEACH WILLIAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1205575115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEKEISHA LEACH WILLIAMS

Provider Business Mailing Address
First Line	:	2121 ARLINGTON AVE NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-4718
Country	:	US
Telephone Number	:	380-212-2009
Fax Number	:	380-979-9190

Provider Business Practice Location Address
First Line	:	2121 ARLINGTON AVE NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-4718
Country	:	US
Telephone Number	:	380-212-2009
Fax Number	:	380-979-9190

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2022
Last Update Date	:	12/21/2025

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