Individual
JOHN C WIESCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCMHC, LCPC, LMHC
Contact information
Practice address
2435 KIMBERLY RD STE 270, BETTENDORF, IA 52722-3509
(406) 220-6262
Mailing address
1844 1ST ST, EAST MOLINE, IL 61244-2410
(309) 981-0364
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.011783
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090936
STATE LICENSE
IA
01
—
180.013607
STATE LICENSE
IL
Enumeration date
11/06/2017
Last updated
05/13/2025
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