Provider Demographics
NPI:1740045434
Name:WILLIAMS, TANESHA (RPT,RMA,BSHM)
Entity type:Individual
Prefix:
First Name:TANESHA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RPT,RMA,BSHM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8323 GARFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-1272
Mailing Address - Country:US
Mailing Address - Phone:216-678-0897
Mailing Address - Fax:
Practice Address - Street 1:8323 GARFIELD BLVD
Practice Address - Street 2:
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-1272
Practice Address - Country:US
Practice Address - Phone:216-467-0840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty