Provider Demographics
NPI:1629685011
Name:WILLIAMS, MIOSHA (LMHC)
Entity Type:Individual
Prefix:
First Name:MIOSHA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7434 WHITCOMB ST APT C
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-4491
Mailing Address - Country:US
Mailing Address - Phone:219-381-0105
Mailing Address - Fax:
Practice Address - Street 1:7434 WHITCOMB ST APT C
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-4491
Practice Address - Country:US
Practice Address - Phone:219-381-0105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
IN39004625A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst