Provider Demographics
NPI:1295064558
Name:WILLIAMS, JAMES MASHAUN (CSAC, LPC-IT, CSIT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MASHAUN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:CSAC, LPC-IT, CSIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 N MAIN ST STE 501
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-4952
Mailing Address - Country:US
Mailing Address - Phone:920-479-1087
Mailing Address - Fax:
Practice Address - Street 1:404 N MAIN ST STE 501
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-4952
Practice Address - Country:US
Practice Address - Phone:920-479-1087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15549-132101YA0400X
WI1515-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional