Provider Demographics
NPI:1275404618
Name:WILLIAMS, TAKESHIA DE'SHAUN
Entity type:Individual
Prefix:
First Name:TAKESHIA
Middle Name:DE'SHAUN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 N 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-1509
Mailing Address - Country:US
Mailing Address - Phone:225-223-7107
Mailing Address - Fax:
Practice Address - Street 1:9171 COCKERHAM RD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-2255
Practice Address - Country:US
Practice Address - Phone:225-939-3656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty