Provider Demographics
NPI:1659738359
Name:HUSELTON, JAMES D II (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:HUSELTON
Suffix:II
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9256 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-6466
Mailing Address - Country:US
Mailing Address - Phone:814-807-1316
Mailing Address - Fax:814-336-1156
Practice Address - Street 1:18320 CONNEAUT LAKE RD
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3740
Practice Address - Country:US
Practice Address - Phone:814-807-1316
Practice Address - Fax:814-336-1156
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008561101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor