Provider Demographics
NPI:1972702991
Name:WILLIAMS, REISHA LYNN (LCPC)
Entity type:Individual
Prefix:MS
First Name:REISHA
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 N HALSTED ST
Mailing Address - Street 2:107
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-6599
Mailing Address - Country:US
Mailing Address - Phone:773-617-7188
Mailing Address - Fax:
Practice Address - Street 1:525 N HALSTED ST
Practice Address - Street 2:107
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-6599
Practice Address - Country:US
Practice Address - Phone:773-617-7188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health