Provider Demographics
NPI:1689946618
Name:WILLIAMS, YAHSHANAH (LCSW)
Entity type:Individual
Prefix:
First Name:YAHSHANAH
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 DIXIE HIGHWAY
Mailing Address - Street 2:SUITE 4 BOX 193
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258
Mailing Address - Country:US
Mailing Address - Phone:502-625-5080
Mailing Address - Fax:502-305-6649
Practice Address - Street 1:6707 FENSKE LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-4607
Practice Address - Country:US
Practice Address - Phone:502-625-5080
Practice Address - Fax:502-305-6649
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2596481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7101015100Medicaid