Provider Demographics
NPI:1962415406
Name:EASON-WILLIAMS, PAULETTE R (LCPC, CADC)
Entity type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:R
Last Name:EASON-WILLIAMS
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 W. BEVERLY GLEN PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643
Mailing Address - Country:US
Mailing Address - Phone:773-238-5555
Mailing Address - Fax:773-238-5533
Practice Address - Street 1:1222 W. 95TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643
Practice Address - Country:US
Practice Address - Phone:773-238-5555
Practice Address - Fax:773-238-5533
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL13958101YA0400X
IL180-005158101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)