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Individual
PE GERARD WEIDEMAN
Active
Individual
PE GERARD WEIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, MSW, LPCC, LADAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
005438
NM
101YM0800X
Mental Health Counselor
Primary
005849
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A9813
—
NM
Enumeration date
08/22/2006
Last updated
04/18/2009
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