Provider Demographics
NPI:1285918896
Name:WILLIAMS, TI'AUNA LA'COLE (MA, CSAYC)
Entity type:Individual
Prefix:MS
First Name:TI'AUNA
Middle Name:LA'COLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, CSAYC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6204 E 55TH PL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-1646
Mailing Address - Country:US
Mailing Address - Phone:317-721-7398
Mailing Address - Fax:
Practice Address - Street 1:5023 E 56TH ST
Practice Address - Street 2:SUITE 130
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-1474
Practice Address - Country:US
Practice Address - Phone:317-543-9347
Practice Address - Fax:317-543-9357
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health