Holly J Weerasekera, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1449 Issued in TN

Practice address

63 N Ocoee St
Cleveland, TN 37311-5065

Phone

(423) 458-1640

NPI assigned

Aug 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 12, 2024 through Jan 12, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1376261537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 N OCOEE ST",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373115065",
            "telephone_number": "423-458-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 N OCOEE ST",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373115065",
            "telephone_number": "423-458-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEERASEKERA",
        "first_name": "HOLLY",
        "middle_name": "J",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "1449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wholeheartedcounselingmft@outlook.com",
            "affiliation": "N",
            "endpointDescription": "WORK EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "63 N Ocoee St",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373115065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nancy Ann Wellman, PHARM D
• Eston K. Wenger, MD

• Marriage & Family Therapist in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Marriage & Family Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.