Individual provider Active NPI

Jill A Weiterman, MS, LPC

  • Professional Counselor
  • Independence, MO
National Provider Identifier
1831618552
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2013000300 Issued in MO
Practice address
17844 E 23Rd St S
Independence, MO 64057-1840
Phone
(816) 254-3652
NPI assigned
Sep 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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 2013000300 MO Primary

Addresses

Primary practice location

17844 E 23Rd St S
Independence, MO 64057-1840

Mailing address

17844 E 23Rd St S
Independence, MO 64057-1840
Phone (816) 254-3652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20231204002291 MO Practitioner - Mental Health Counselor 8628426434 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2013000300MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Burrell, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Burrell, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

17611 E US Highway 24
Independence, MO 64056
Phone (816) 836-6350

17611 E US Highway 24
#H
Independence, MO 64056
Phone (816) 836-6350

17844 E 23rd St S
Independence, MO 64057
Phone (816) 257-9716

2885 W Battlefield St
Springfield, MO 65807
Phone (417) 761-5214

Organizations & group practices 2

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": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1831618552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17844 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571840",
            "telephone_number": "816-254-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17844 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571840",
            "telephone_number": "816-254-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITERMAN",
        "first_name": "JILL",
        "middle_name": "A",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2013000300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.