Wieberg, James

Wieberg, James is an individual health care provider with primary practice located at 1432 Southwest Blvd , Jefferson City MO 65109. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Wieberg, James can be contacted via phone (573) 632-5560.

Contact Information

Primary practice address
1432 Southwest Blvd Jefferson City MO 65109
Phone: (573) 632-5560
Fax: (573) 632-5875
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 612 Missouri

Profile Details

NPI number 1689614596
LBN Legal business name Wieberg, James
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Jul 1st, 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 1689614596 NPPES
Missouri MEDICAID 493618003
Missouri Other 109949

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