Provider Demographics
NPI:1306470570
Name:WILLIAMS, KEISHA CHRISTINA (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:KEISHA
Middle Name:CHRISTINA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:KEISHA
Other - Middle Name:CHRISTINA
Other - Last Name:IGESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:6949 W GLENBROOK RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-1111
Mailing Address - Country:US
Mailing Address - Phone:414-745-4028
Mailing Address - Fax:
Practice Address - Street 1:620 S 76TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-1599
Practice Address - Country:US
Practice Address - Phone:414-453-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7621-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional