MEDICARE: JEANINE 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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1427993054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEANINE WILLIAMS

Provider Business Mailing Address
First Line	:	8448 E 100 N
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47905-8741
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8448 E 100 N
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47905-8741
Country	:	US
Telephone Number	:	765-491-1952
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEANINE WILLIAMS
Credential	:
Telephone Number	:	765-491-1952

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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Directions to “JEANINE WILLIAMS ” Practice Location

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