Active NPI
Roger Robert Wohldmann, LPC, CASAC
- Counselor
- O'Fallon, MO
National Provider Identifier
1265505580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 1999143405
- Practice address
- 214 Church St
O Fallon, MO 63366-2814 - Phone
- (314) 703-2721
- NPI assigned
- Nov 16, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 1999143405 | MO | Primary |
Addresses
Primary practice location
214 Church St
O Fallon, MO 63366-2814
Mailing address
214 Church St
O Fallon, MO 63366-2814
Phone (314) 703-2721
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1999143405 | MO | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265505580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 CHURCH ST",
"city": "O FALLON",
"state": "MO",
"postal_code": "633662814",
"telephone_number": "314-703-2721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 CHURCH ST",
"city": "O FALLON",
"state": "MO",
"postal_code": "633662814",
"telephone_number": "314-703-2721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOHLDMANN",
"first_name": "ROGER",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "LPC, CASAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MO",
"license": "1999143405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O'Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.