MEDICARE: SHALLEIGH MARIE WILLIAMS LADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1295452076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHALLEIGH MARIE WILLIAMS LADC

Provider Business Mailing Address
First Line	:	37 BIRCH DR
Second Line	:
City	:	STANDISH
State	:	ME
Zip	:	04084-6665
Country	:	US
Telephone Number	:	207-396-0152
Fax Number	:

Provider Business Practice Location Address
First Line	:	770 ROOSEVELT TRL STE 8
Second Line	:
City	:	NORTH WINDHAM
State	:	ME
Zip	:	04062-5300
Country	:	US
Telephone Number	:	207-300-2471
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2022
Last Update Date	:	03/02/2026

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