Provider Demographics
NPI:1821241258
Name:ISLEY, WILLIAM C (PLADC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:ISLEY
Suffix:
Gender:M
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 U
Mailing Address - Street 2:#2
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503
Mailing Address - Country:US
Mailing Address - Phone:402-601-3613
Mailing Address - Fax:
Practice Address - Street 1:1700 SOUTH 24
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502
Practice Address - Country:US
Practice Address - Phone:402-435-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-503101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)