Joellyn Weidman, P.C.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E6855 Issued in OH

Practice address

239A Old National Rd
Old Washington, OH 43768-0094

Phone

(740) 489-5571

Fax

(740) 489-5004

NPI assigned

Mar 3, 2014

Last updated

May 23, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/southeasternohiocounseling/r4/

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

• Southeastern Ohio Counseling Center, LLC.

  • Community/Behavioral Health Agency
  • Old Washington, OH
  • NPI 1306459821
  NPD (past)
• Southeastern Ohio Counseling Center, LLC.

  • Community/Behavioral Health Agency
  • Old Washington, OH
  • NPI 1679844526
  NPD (past)

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1205251055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94",
            "city": "OLD WASHINGTON",
            "state": "OH",
            "postal_code": "437680094",
            "telephone_number": "740-489-5571",
            "fax_number": "740-489-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239A OLD NATIONAL RD",
            "city": "OLD WASHINGTON",
            "state": "OH",
            "postal_code": "437680094",
            "telephone_number": "740-489-5571",
            "fax_number": "740-489-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDMAN",
        "first_name": "JOELLYN",
        "credential": "P.C.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-03",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E6855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harlie Taylor
• Penny Tindall
• Stacy Vandyne
• Laken Waggoner
• Jacey Wayble
• Kelsey Wolfe
• Kylie Wright

• Professional Counselor in Old Washington, OH
• Providers in Old Washington, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.