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NPI Code Detail

MEDICARE: MICHELE WILLIAMS CSAC, CS-IT

MEDICARE: MICHELE WILLIAMS CSAC, CS-IT
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
1101YA0400XAddiction (Substance Use Disorder) Counselor15240-130WI
2101YA0400XAddiction (Substance Use Disorder) Counselor15443-132WI
3101YA0400XAddiction (Substance Use Disorder) Counselor15465-133WI

General Provider Information

NPI Number : 1710281456
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE WILLIAMS CSAC, CS-IT
Provider Business Mailing Address
First Line : 2618 N BREMEN ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3003
Country : US
Telephone Number : 414-977-1200
Fax Number : 414-962-2305
Provider Business Practice Location Address
First Line : 2618 N BREMEN ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3003
Country : US
Telephone Number : 414-977-1200
Fax Number : 414-962-2305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2011
Last Update Date : 09/23/2014

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Directions to “ MICHELE WILLIAMS CSAC, CS-IT” Practice Location

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