Healthcare Provider Details

I. General information

NPI: 1174459630
Provider Name (Legal Business Name): JAMES CHRISTOPHER MAHLAN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E WISCONSIN AVE STE 1500
MILWAUKEE WI
53202-4808
US

IV. Provider business mailing address

111 E WISCONSIN AVE STE 1500
MILWAUKEE WI
53202-4808
US

V. Phone/Fax

Practice location:
  • Phone: 141-436-1270
  • Fax:
Mailing address:
  • Phone: 141-436-1270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12358-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: