Jeffrey Peter Wedge, LCMHC, MLADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2295 Issued in NH

Practice address

14A Tsienneto Rd
Derry, NH 03038-1505

Phone

(603) 537-1300

Fax

(603) 845-5135

NPI assigned

Jan 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Derry Medical Center, PAGroup PAC ID 5294711768, 98 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Derry Medical Center, PA

  • Family Medicine Physician
  • Derry, NH
  • NPI 1922030493
  Medicare reassignment Care Compare group NPD
• Elliot Hospital of the City of Manchester

  • Durable Medical Equipment & Medical Supplies
  • Manchester, NH
  • NPI 1689764482
  NPD (past)
• The Mental Health Center of Greater Manchester

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manchester, NH
  • NPI 1609848811
  NPD (past)

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1770057291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 TSIENNETO RD BLDG B",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381647",
            "telephone_number": "603-537-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14A TSIENNETO RD",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381505",
            "telephone_number": "603-537-1300",
            "fax_number": "603-845-5135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Tarrytown Rd",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031032713",
            "country_code": "US",
            "telephone_number": "603-663-4472",
            "fax_number": "603-296-2232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Wall St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "03101",
            "country_code": "US",
            "telephone_number": "603-668-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEDGE",
        "first_name": "JEFFREY",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "LCMHC, MLADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-17",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "0431",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "2295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2 Wall St Ste 300",
            "city": "Manchester",
            "state": "NH",
            "country_code": "US",
            "postal_code": "03101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anne Walsh
• Megan Ann Waring
• Kelley Watkins, APRN
• Katrina Adele Wayman, CNM
• Judah David Weathers, M.D.
• John Francis Welter, DO
• Rebecca Katherine Wessling, PA-C
• Nicole West
• Sarah West
• Beverly Stasia Weston

• Mental Health Counselor in Derry, NH
• Providers in Derry, NH by specialty
• Mental Health Counselor in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.