Provider Demographics
NPI:1902636277
Name:WILLIAMS, KARA VANETTA (MS, LPC-IT)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:VANETTA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 N PROSPECT AVE APT 215
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1925
Mailing Address - Country:US
Mailing Address - Phone:224-358-8389
Mailing Address - Fax:
Practice Address - Street 1:2600 N MAYFAIR RD STE 400
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1306
Practice Address - Country:US
Practice Address - Phone:414-939-9390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7998226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty