Weideman, Pe Gerard

Weideman, Pe Gerard is an individual health care provider with primary practice located at 501 W Pine St , Deming NM 88030-3530. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Weideman, Pe Gerard can be contacted via phone (505) 541-1695.

Contact Information

Primary practice address
501 W Pine St Deming NM 88030-3530
Phone: (505) 541-1695
Fax: (505) 647-3033
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 005438 New Mexico
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 005849 New Mexico

Profile Details

NPI number 1639285638
LBN Legal business name Weideman, Pe Gerard
Credentials MS, MSW, LPCC, LADAC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2006
Last updated Apr 18th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639285638 NPPES
New Mexico MEDICAID A9813

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