Individual provider Active NPI

Carolyn Jane Weimer, LPC

  • Professional Counselor
  • Pittsburgh, PA
National Provider Identifier
1114389558
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC007594 Issued in PA
Practice address
239 4TH Ave Ste 1801
Pittsburgh, PA 15222-1716
Phone
(412) 532-1249
NPI assigned
Mar 24, 2016
Reactivated
Jul 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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 PC007594 PA Primary

Addresses

Primary practice location

239 4TH Ave Ste 1801
Pittsburgh, PA 15222-1716

Mailing address

830 Western Ave
Pittsburgh, PA 15233-1716
Phone (412) 322-2129

Other practice location 1

830 Western Ave
Pittsburgh, PA 15233-1716
Phone (412) 322-2129

Other identifiers 1

IdentifierTypeStateIssuer
PC007594OtherPACOMMONWEALTH OF PENNSYLVANIA

Other names 1

  • Ms. Carolyn Jane Ewalt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PC007594PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Evidence Based Therapy & Wellness LLC Professional CurrentSince May 10, 2026 Accepting new patients
Counseling and Wellness Center of Pittsburgh Professional PastSince Dec 3, 2023 Accepting new patients

Locations

239 4th Ave
Ste 1801
Pittsburgh, PA 15222
Phone (412) 532-1249

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1114389558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 WESTERN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152331716",
            "telephone_number": "412-322-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 4TH AVE STE 1801",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152221716",
            "telephone_number": "412-532-1249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Western Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152331716",
            "country_code": "US",
            "telephone_number": "412-322-2129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIMER",
        "first_name": "CAROLYN",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "deactivation_date": "2019-07-19",
        "reactivation_date": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC007594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF PENNSYLVANIA",
            "identifier": "PC007594",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "EWALT",
            "middle_name": "JANE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.