Alexander Widas, BS, LMT, CHT, REV

Primary specialty

CounselorTaxonomy code 101Y00000X

License

097.0135085 Issued in VT

Practice address

323 Wilson Way
Larkspur, CA 94939-1938

Phone

(609) 351-1988

NPI assigned

Jun 29, 2022

Last updated

Nov 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1114659927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 REDSTONE BLVD",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816238926",
            "telephone_number": "609-351-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 WILSON WAY",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391938",
            "telephone_number": "609-351-1988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 Church St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054014482",
            "country_code": "US",
            "telephone_number": "609-351-1988",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "306 Redstone Blvd",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "CO",
            "postal_code": "816238926",
            "country_code": "US",
            "telephone_number": "609-351-1988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIDAS",
        "first_name": "ALEXANDER",
        "credential": "BS, LMT, CHT, REV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT.0024401",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VT",
            "license": "164.0000760",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VT",
            "license": "097.0135085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Larkspur, CA
• Providers in Larkspur, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.