Individual provider Active NPI

Shamia Williams

  • Mental Health Counselor
  • Gurnee, IL
National Provider Identifier
1124854005
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178.018067 Issued in IL
Practice address
135 N Greenleaf St Ste 120
Gurnee, IL 60031-3334
Phone
(224) 285-0728
NPI assigned
Sep 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.018067 IL Primary

Addresses

Primary practice location

135 N Greenleaf St Ste 120
Gurnee, IL 60031-3334

Mailing address

135 N Greenleaf St Ste 120
Gurnee, IL 60031-3334
Phone (224) 285-0728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250508002416 IL Practitioner - Mental Health Counselor 9032636402 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.018067ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ganesha Institute of Neurology and Psychiatry SC CurrentSince Mar 7, 2025 Accepting new patients
Tabularasa Integrative Health Inc CurrentSince Sep 15, 2024 Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC CurrentSince Mar 7, 2025 Accepting new patients

Locations

135 N Greenleaf St
Ste 120
Gurnee, IL 60031
Phone (224) 285-0728

1850 W Winchester Rd
Ste 115
Libertyville, IL 60048
Phone (847) 816-6335

1860 W Winchester Rd
Ste 106
Libertyville, IL 60048
Phone (847) 599-0715

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1124854005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N GREENLEAF ST STE 120",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313334",
            "telephone_number": "224-285-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N GREENLEAF ST STE 120",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313334",
            "telephone_number": "224-285-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHAMIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.018067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.