LYNDSEY WIDEMAN (NPI# 1487287835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487287835 |
Entity Type | Individual |
Full Name | LYNDSEY WIDEMAN |
Practice Address |
2311 S Illinois Ave Carbondale IL 62903-5912 |
Mailing Address |
902 W Main St West Frankfort IL 62896-2210 |
Practice Telephone | 6184576703 |
Practice Fax Number | 6185493734 |
Mailing Telephone | 6189376483 |
Mailing Fax Number | 6189371440 |
Enumeration Date | 2020-02-13 |
Last Update Date | 2020-02-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | IL2970 | 05 |
Street Address |
2311 S ILLINOIS AVE |
City | CARBONDALE |
State | IL |
Zip Code | 62903-5912 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316282130 | Centerstone of Illinois, Inc | Community/Behavioral Health | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2012-12-05 |
1861009128 | Ashley Pruett | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-09-30 |
1477167823 | Zachary Woosley | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-09-03 |
1215553110 | Margaret K Henry | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-06-17 |
1053934489 | Matthew Picchietti | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-05-20 |
1124659024 | Matthew Leigh | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-01-29 |
1447890199 | Nicholas Foy | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-01-10 |
1841769064 | Bonnie Bean | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2018-11-16 |
1609344308 | Allison Lence | Registered Nurse | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2018-11-12 |
1790253268 | Elsie Farough | Social Worker | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2018-11-02 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447625918 | Integrative Spine Care, LLC | Pain Medicine | 364 Lake Indian Hills Circle, Carbondale, IL 62903 | 2015-12-09 |
1811949910 | Devon G Barnes | Nurse Anesthetist, Certified Registered | 35 Albany Road, Suite C, Carbondale, IL 62903 | 2006-05-17 |
1033516950 | Centerstone of Illinois, Inc | Community Based Residential Treatment Facility, Mental Illness | 2411 S Illinois Ave, Carbondale, IL 62903-5913 | 2014-11-20 |
1447804174 | Ayla Schmick | Behavioral Analyst | 2200 S Illinois Ave Apt 15, Carbondale, IL 62903-5964 | 2019-07-31 |
1528680162 | Mitchell Wayne Sanders | Student in an Organized Health Care Education/Training Program | 2350 S Illinois Ave Apt 8b, Carbondale, IL 62903-5977 | 2020-05-16 |
1487262358 | Chloe Lenoir | Behavior Technician | 2310 S Illinois Ave Apt B3, Carbondale, IL 62903-5988 | 2020-07-16 |
1609943091 | Virgil A Beadle | Dentist | #4 Crown Lane, Carbondale, IL 62903-7604 | 2006-11-29 |
1639223464 | James David Wade | Nurse Anesthetist, Certified Registered | 35 Albany Rd Ste C, Carbondale, IL 62903-7605 | 2007-01-22 |
1255333118 | Jai P. Singh | Anesthesiology | 35 Albany Rd, Suite C, Carbondale, IL 62903-7605 | 2005-08-11 |
1033218086 | Jane Kidwell | Counselor | 35 Albany Rd, Suite E, Carbondale, IL 62903-7605 | 2006-09-22 |
Find all providers in zip 62903 |
Taxonomy Code | 101Y00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831716844 | Valerie Newton | Counselor | 200 N Emerald Ln Ste 3, Carbondale, IL 62901-2170 | 2020-06-26 |
1235761784 | Ashley Ettinger | Counselor | 38 North Scott Road, Carbondale, PA 18407 | 2020-02-12 |
1356621528 | John Cosmo Obell | Counselor | 6 N Church St, St. Rose Rectory, Carbondale, PA 18407-2393 | 2011-08-19 |
1437456522 | Mary Elisabeth Jackson | Counselor | 804 South Oakland Ave, Carbondale, IN 62901 | 2011-02-25 |
1124299706 | Bonnie M Henry | Counselor | 602 S Wedgewood Ln, Carbondale, IL 62901-2119 | 2008-03-21 |
1699376517 | Taylor Holloway | Counselor | 200 N Emerald Ln Ste 3, Carbondale, IL 62901-2170 | 2020-11-06 |
1861009128 | Ashley Pruett | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-09-30 |
1477167823 | Zachary Woosley | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-09-03 |
1225648652 | Trisha Fuller | Counselor | 200 N Emerald Ln, Carbondale, IL 62901-2159 | 2020-07-31 |
1043829450 | Chelsea Oschs | Counselor | 200 N Emerald Ln, Carbondale, IL 62901-2159 | 2020-07-31 |
Find all providers in CARBONDALE |
City | CARBONDALE |
Zip Code | 62903 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.