Active NPI
Donald Weatherall
- Addiction (Substance Use Disorder) Counselor
- Milwaukee, WI
National Provider Identifier
1851752455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 10917
- Practice address
- 2821 N 4TH St
Milwaukee, WI 53212-2362 - Phone
- (414) 372-9542
- NPI assigned
- Mar 10, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 10917 | WI | Primary |
| Clinical Neuropsychologist | 103G00000X | 10917 | WI |
Addresses
Primary practice location
2821 N 4TH St
Milwaukee, WI 53212-2362
Mailing address
2821 N 4TH St
Milwaukee, WI 53212-2362
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457568000000",
"number": "1851752455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2821 N 4TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532122362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2821 N 4TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532122362",
"telephone_number": "414-372-9542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEATHERALL",
"first_name": "DONALD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-10",
"last_updated": "2016-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "10917",
"primary": true
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "WI",
"license": "10917",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.