Whitney Wollweber
Individual provider Active NPI Professional Counselor · Edwall, WA
NPI 1962128397 · NPPES record last updated Jun 2, 2024
Key facts
- NPI
- 1962128397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC-9772 (ID)
- Practice address
- 16020 Polenske Rd N
Edwall, WA 99008-9631 - Phone
- (509) 995-4501
- NPI assigned
- Oct 17, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-9772 | ID | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-9772 | ID | Yes |
| Counselor |
101Y00000X |
Addresses
Primary practice location
16020 Polenske Rd N
Edwall, WA 99008-9631
Mailing address
3091 N Atlas Rd Unit H305
Coeur D Alene, ID 83814-6363
Phone (509) 995-4501
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NONE | Other | NONE |
Other providers in Edwall, WA
All providers in Edwall, WA · Professional Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.