Individual
CAROLINE WEIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
904 SOUTH ST, LAFAYETTE, IN 47901-1416
(765) 630-7222
(765) 630-7905
Mailing address
904 SOUTH ST, LAFAYETTE, IN 47901-1416
(765) 630-7222
(765) 630-7905
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
88000803A
IN
101YM0800X
Mental Health Counselor
Primary
88000803A
—
Other
Enumeration date
03/13/2019
Last updated
10/05/2020
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