Provider Demographics
NPI:1285116475
Name:WILLIAMS, MARKESHA (LCSW)
Entity type:Individual
Prefix:
First Name:MARKESHA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9412 S SACRAMENTO AVE
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2428
Mailing Address - Country:US
Mailing Address - Phone:815-505-0384
Mailing Address - Fax:
Practice Address - Street 1:9412 S SACRAMENTO AVE
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2428
Practice Address - Country:US
Practice Address - Phone:815-505-0384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490205701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty