Provider Demographics
NPI:1275645913
Name:WILLIAMS, JANETTE RENEE (LCPC)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:RENEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:JANETTE
Other - Middle Name:RENEE
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 MOONEY DR STE 1
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-2172
Mailing Address - Country:US
Mailing Address - Phone:815-370-6146
Mailing Address - Fax:815-933-7890
Practice Address - Street 1:110 MOONEY DR STE 1
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-2172
Practice Address - Country:US
Practice Address - Phone:815-933-7887
Practice Address - Fax:815-933-7870
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004866101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional