Tanisha Jonique Willis, MHC-MP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P134431

Practice address

66A Medford Ave
Patchogue, NY 11772-1202

Phone

(631) 730-5250

NPI assigned

Jul 14, 2025

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

Other names 1

• Tanisha Jonique Arnold Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1831080290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MILL RD # 1405",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117791400",
            "telephone_number": "516-965-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66A MEDFORD AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721202",
            "telephone_number": "631-730-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "TANISHA",
        "middle_name": "JONIQUE",
        "credential": "MHC-MP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "P134431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANISHA",
            "last_name": "ARNOLD",
            "middle_name": "JONIQUE",
            "credential": "MCH-LP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wholistic Counseling, P.C.
• Jessie Wilkinson, LCSW
• Michael C. Williams II, P.T.
• Shamella Williams
• Erica Regina Williamson, LPN
• Suzanne M. Willoughby, LCAT, MT-BC
• John Lowe Wilson, PT
• Lisa Wilson
• Zar CHI Win, M.D
• Jason Allen Winslow, MD

• Mental Health Counselor in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.