Healthcare Provider Details

I. General information

NPI: 1154925972
Provider Name (Legal Business Name): JAMES WILLIAM MAYHAN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2020
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 14010 BLDG. 26012 ANDERSEN AFB
APO AP
96543-4003
US

IV. Provider business mailing address

UNIT 14010 BLDG. 26012 ANDERSEN AFB
APO AP
96543-4003
US

V. Phone/Fax

Practice location:
  • Phone: 671-366-5125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: