Provider Demographics
NPI:1144980905
Name:MCWILLIAMS, CAMERON TAYLOR (MS, BCBA)
Entity type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:TAYLOR
Last Name:MCWILLIAMS
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 KENILWORTH CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-3032
Mailing Address - Country:US
Mailing Address - Phone:765-413-2490
Mailing Address - Fax:
Practice Address - Street 1:3482 MCCLURE AVE
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-4164
Practice Address - Country:US
Practice Address - Phone:765-838-3547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-21-56547103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst