Individual provider Active NPI

Andrew Robert Wichterman, LPC

  • Professional Counselor
  • Kalamazoo, MI
National Provider Identifier
1689808743
Registry record updated May 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401010249 Issued in MI
Practice address
1090 N 10TH St
Kalamazoo, MI 49009-5733
Phone
(269) 375-4363
NPI assigned
May 5, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401010249 MI Primary

Addresses

Primary practice location

1090 N 10TH St
Kalamazoo, MI 49009-5733

Mailing address

204 Colorado St
Battle Creek, MI 49037-1014
Phone (269) 274-2028

Other identifiers 1

IdentifierTypeStateIssuer
26-2835726OtherMISTATE OF MICHIGAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401010249MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Counseling Professionals LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241481600000",
    "number": "1689808743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 COLORADO ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490371014",
            "telephone_number": "269-274-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 N 10TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490095733",
            "telephone_number": "269-375-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHTERMAN",
        "first_name": "ANDREW",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "26-2835726",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.