PE GERARD WEIDEMAN MS MSW LPCC LADAC NPI 1639285638

NPI Information

NPI: 1639285638
Provider Name: PE GERARD WEIDEMAN, MS, MSW, LPCC, LADAC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
501 W PINE ST
DEMING, NM
ZIP 88030
Phone: (505) 541-1695
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Pe Gerard Weideman, MS, MSW, LPCC, LADAC is a mental health counselor in Deming, NM. Pe Gerard Weideman, MS, MSW, LPCC, LADAC NPI is 1639285638. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

501 W PINE ST
DEMING, NM
ZIP 88030-530
Phone: (505) 541-1695
Fax: (505) 647-3033

The enumeration date for this NPI number is 8/22/2006 and was last updated on 4/18/2009.

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
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	005438	NEW MEXICO	No
2	101YM0800X	Counselor	Mental Health	005849	NEW MEXICO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A9813	MEDICAID	NEW MEXICO

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: 11/14/2023

NPI Synchronization or Removal

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