Pamela Jean Wieters, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-38063 Issued in ID

Practice address

428 6TH Ave
Lewiston, ID 83501-2355

Phone

(208) 799-6500

NPI assigned

Jun 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Sequoia Counseling Services, Inc.

  • Mental Health Counselor
  • Lewiston, ID
  • NPI 1386778959

  Social Worker

  NPD (past)

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1649629700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 BRYDEN AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014438",
            "telephone_number": "208-798-1646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 6TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012355",
            "telephone_number": "208-799-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETERS",
        "first_name": "PAMELA",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-27529",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-38063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael N Whisenant, MD
• Brandy Lynn Whitcomb
• Allyson Whiting, DPT
• Mark Steven Whitinger, M.A., LCPC
• Wholehearted Counseling Service
• Curtis E Wiggins, DDS
• Jeremy C Wiggins, DDS
• Wilkinson Orthodontics
• Katherine Elizabeth Bryan Willard, PHARMD
• William R. Bozarth, M.D., P.S.

• Clinical Social Worker in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.