Individual provider Active NPI

Eric Wettstein, RMHCI

  • Mental Health Counselor
  • Longwood, FL
National Provider Identifier
1376937904
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12875 Issued in FL
Practice address
480 Winding Creek PL
Longwood, FL 32779-6117
Phone
(407) 733-3317
NPI assigned
Mar 20, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12875 FL Primary

Addresses

Primary practice location

480 Winding Creek PL
Longwood, FL 32779-6117

Mailing address

480 Winding Creek PL
Longwood, FL 32779-6117

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

LicenseStateTypeSpecialty
12875FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1426809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1376937904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 WINDING CREEK PL",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327796117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 WINDING CREEK PL",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327796117",
            "telephone_number": "407-733-3317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTSTEIN",
        "first_name": "ERIC",
        "credential": "RMHCI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-20",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "12875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.