Provider Demographics
NPI:1225929730
Name:WILLIAMS, TAMEKA (LGP)
Entity type:Individual
Prefix:
First Name:TAMEKA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 IMPERIAL DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1831
Mailing Address - Country:US
Mailing Address - Phone:410-963-6314
Mailing Address - Fax:
Practice Address - Street 1:8201 IMPERIAL DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1831
Practice Address - Country:US
Practice Address - Phone:410-963-6314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-12
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP16677101YP2500X, 101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)