Active NPI
Joseph R. Wideman, M.S., C.A.C., L.P.C.
- Professional Counselor
- Scranton, PA
National Provider Identifier
1720290497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC003225
- Practice address
- 1002 Pittston Ave
Scranton, PA 18505-4169 - Phone
- (570) 344-2676
- Fax
- (570) 344-6794
- NPI assigned
- May 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC003225 | PA | Primary |
Addresses
Primary practice location
1002 Pittston Ave
Scranton, PA 18505-4169
Mailing address
1002 Pittston Ave.
Scranton, PA 18505
Phone (570) 344-2676
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC003225 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720290497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1002 PITTSTON AVE.",
"city": "SCRANTON",
"state": "PA",
"postal_code": "18505",
"telephone_number": "570-344-2676",
"fax_number": "570-344-6794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 PITTSTON AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185054169",
"telephone_number": "570-344-2676",
"fax_number": "570-344-6794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDEMAN",
"first_name": "JOSEPH",
"middle_name": "R.",
"credential": "M.S., C.A.C., L.P.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC003225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- 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.