Provider Demographics
NPI:1114104437
Name:WILLIAMS, SEBASTION A (MSED, LCPC, CCM)
Entity type:Individual
Prefix:MR
First Name:SEBASTION
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MSED, LCPC, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 212
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429
Mailing Address - Country:US
Mailing Address - Phone:708-252-8228
Mailing Address - Fax:312-829-0710
Practice Address - Street 1:P.O. BOX 212
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429
Practice Address - Country:US
Practice Address - Phone:708-252-8228
Practice Address - Fax:312-829-0710
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-002011101YM0800X
IL180-02011101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional