TYANN WIEDERHOLT NPI 1033034749

NPI Information

  • NPI: 1033034749
  • Provider Name: TYANN WIEDERHOLT
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 200 NE MISSOURI RD
    LEES SUMMIT, MO
    ZIP 64086
  • Phone: (636) 579-0906

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NPI Details

Tyann Wiederholt is a mental health counselor in Lees Summit, MO. Tyann Wiederholt NPI is 1033034749. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

200 NE MISSOURI RD
LEES SUMMIT, MO
ZIP 64086-722
Phone: (636) 579-0906

The enumeration date for this NPI number is 8/11/2026 and was last updated on 8/11/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental Health2026034217MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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