Provider Demographics
NPI:1083040810
Name:WILLIAMS, AISHIA L (LPC)
Entity Type:Individual
Prefix:DR
First Name:AISHIA
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:DR
Other - First Name:AISHIA
Other - Middle Name:
Other - Last Name:LEVERETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:607 CALDWELL PL
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-5760
Mailing Address - Country:US
Mailing Address - Phone:706-231-6261
Mailing Address - Fax:706-869-7380
Practice Address - Street 1:607 CALDWELL PL
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-5760
Practice Address - Country:US
Practice Address - Phone:706-231-6261
Practice Address - Fax:706-869-7380
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCAC II101Y00000X, 101YA0400X
GA3076-R101YA0400X
GALPC008747101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC570569761OtherTAX ID
SCAD01AKMedicaid