Ebony De-Shonia Willis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401223961 Issued in MI

Practice address

835 Mason St Ste B295-a
Dearborn, MI 48124-2231

Phone

(734) 265-0890

Fax

(734) 895-3957

NPI assigned

Sep 27, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Illuminated Guidance Center LLC

  • Mental Health Counselor
  • Dearborn, MI
  • NPI 1811862451
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1487205787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 MASON ST STE B295-A",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242231",
            "telephone_number": "734-265-0890",
            "fax_number": "734-895-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 MASON ST STE B295-A",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242231",
            "telephone_number": "734-265-0890",
            "fax_number": "734-895-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "EBONY",
        "middle_name": "DE-SHONIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-27",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401223961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Williams
• Trenale Onita Williams
• Tresa Williams
• Vera Williams
• Alexa Williamson
• Nivea Sharonann Willis
• Redell Willis
• David Wilpula, PHARM.D., BCPS
• Latricia Wilson-Meaux
• Ariana A Wilson, OTR

• Mental Health Counselor in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.