Provider Demographics
NPI:1225489271
Name:WILLIAMS, TASHAE (LMHC)
Entity type:Individual
Prefix:MISS
First Name:TASHAE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 W HENRIETTA RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2327
Mailing Address - Country:US
Mailing Address - Phone:585-313-5845
Mailing Address - Fax:585-427-8957
Practice Address - Street 1:2613 W HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2327
Practice Address - Country:US
Practice Address - Phone:585-445-5310
Practice Address - Fax:585-427-8957
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2024-06-06
Deactivation Date:2022-09-06
Deactivation Code:
Reactivation Date:2023-03-10
Provider Licenses
StateLicense IDTaxonomies
NY014805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health