Individual provider Active NPI

Amy Weidert, MS, LPC

  • Professional Counselor
  • Madison, WI
National Provider Identifier
1053029603
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4494 Issued in WI
Practice address
122 W Washington Ave Ste 630
Madison, WI 53703-2758
Phone
(608) 236-4460
NPI assigned
Nov 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4494 WI Primary

Addresses

Primary practice location

122 W Washington Ave Ste 630
Madison, WI 53703-2758

Mailing address

962 Lawrence St
Madison, WI 53715-2039
Phone (608) 395-9243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240315000324 WI Practitioner - Mental Health Counselor 4385080175 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc CurrentSince Feb 3, 2024 Accepting new patients
Inner Edge Psychotherapy, LLC Professional Current Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

16535 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 789-0909

122 W Washington Ave
Ste 630
Madison, WI 53703
Phone (608) 424-8411

440 Science Dr
Ste 300
Madison, WI 53711
Phone (608) 620-7028

10850 W Park Pl
Ste 100
Milwaukee, WI 53224
Phone (414) 361-4100

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1053029603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "962 LAWRENCE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537152039",
            "telephone_number": "608-395-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W WASHINGTON AVE STE 630",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032758",
            "telephone_number": "608-236-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDERT",
        "first_name": "AMY",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.