Diana Weatherall, CADC III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11393 Issued in WI

Practice address

2601 N Dr Martin Luther King Dr
Milwaukee, WI 53212-2711

Phone

(414) 263-8352

Fax

(414) 264-2264

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Access Recovery Mental Health Services

  • Community/Behavioral Health Agency
  • Milwaukee, WI
  • NPI 1154786697
  NPD (past)
• Career Youth Development

  • Addiction (Substance Use Disorder) Counselor
  • Milwaukee, WI
  • NPI 1215195623
  NPD (past)
• Career Youth Development, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Milwaukee, WI
  • NPI 1215928049
  NPD (past)
• Sullivan Medical Clinic, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Milwaukee, WI
  • NPI 1205263159
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366531840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 N DR MARTIN LUTHER KING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122711",
            "telephone_number": "414-263-8352",
            "fax_number": "414-264-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERALL",
        "first_name": "DIANA",
        "name_prefix": "Ms.",
        "credential": "CADC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "11393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39388500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• We Still Have Hope in Our Youth Inc.
• We Transit LLC
• Gentella D Weary, CAREGIVER
• Jasmine Weary
• Tamildro Weary Sr.
• Donald Weatherall
• Suzanne Weathersby
• Dexter Javair Weaver, MS
• Kirsten Weaver
• Web Cast Industries Inc.

• Addiction (Substance Use Disorder) Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• 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.

Verify at the official NPI Registry.