LYNDSEY WIDEMAN


Address: 2311 S Illinois Ave, Carbondale, IL 62903-5912
Phone: 6184576703

LYNDSEY WIDEMAN (NPI# 1487287835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101Y00000X Counselor Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL IL2970 05

Office Location

Street Address 2311 S ILLINOIS AVE
City CARBONDALE
State IL
Zip Code 62903-5912

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City CARBONDALE
Zip Code 62903

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Dataset Information

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.

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