PAMELA JEAN WIETERS


Address: 428 6th Ave, Lewiston, ID 83501-2355
Phone: 2087996500

PAMELA JEAN WIETERS (NPI# 1649629700) 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) 1649629700
Entity Type Individual
Full Name PAMELA JEAN WIETERS
Credential LCSW
Practice Address 428 6th Ave
Lewiston
ID 83501-2355
Mailing Address 531 Bryden Ave
Lewiston
ID 83501-4438
Practice Telephone 2087996500
Mailing Telephone 2087981646
Enumeration Date 2016-06-09
Last Update Date 2019-09-30
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 104100000X Social Worker LMSW-27529 ID Behavioral Health & Social Service Providers
Y 1041C0700X Social Worker
Specialization: Clinical
LCSW-38063 ID Behavioral Health & Social Service Providers

Office Location

Street Address 428 6TH AVE
City LEWISTON
State ID
Zip Code 83501-2355

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205858289 Lynn-marie Morgan Peashka Nurse Practitioner 428 6th Ave, Lewiston, ID 83501-2355 2006-07-25
1043753742 Larry Bearden Counselor 428 6th Ave, Lewiston, ID 83501-2355 2016-11-29
1619328044 Amy Kelley Social Worker 428 6th Ave, Lewiston, ID 83501-2355 2016-06-27
1730541467 Karen Simmons Counselor 428 6th Ave, Lewiston, ID 83501-2355 2016-03-22
1922476845 Alison Lawhead Social Worker 428 6th Ave, Lewiston, ID 83501-2355 2015-09-09
1003284126 St. Joseph's Regional Medical Center General Acute Care Hospital 428 6th Ave, Lewiston, ID 83501-2355 2015-09-05
1013313667 Katherine Ann Troutman Counselor 428 6th Ave, Lewiston, ID 83501-2355 2014-11-10
1619241387 Betty J Weeks Counselor 428 6th Ave, Lewiston, ID 83501-2355 2012-02-28
1609010156 Thadeus B Koontz Psychiatry & Neurology 428 6th Ave, Lewiston, ID 83501-2355 2009-04-28
1235398017 Chivonne Marie Mraz Social Worker 428 6th Ave, Lewiston, ID 83501-2355 2008-06-05
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679193759 Jacqueline M Aldrich Behavior Technician 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 2020-04-20
1295228054 Provident Foundation - Wedgewood Terrace LLC Alzheimer Center (Dementia Center) 2114 Vineyard Avenue, Lewiston, ID 83501 2018-06-07
1164945325 Xiaofei Liu Massage Therapist 234 Thain Rd, Lewiston, ID 83501 2017-07-19
1467909879 Sharon Thulon Registered Nurse 1118 F Street, Lewiston, ID 83501 2016-09-01
1821459496 Gem State Endoscopy Clinic/Center 3709 14th Street, Lewiston, ID 83501 2016-03-10
1508264995 Gary L. Grogan Psychologist 633 Main Street, B#1, Lewiston, ID 83501 2014-12-17
1003189366 John Joseph Johnson Dentist 3510 12th Street, Suite #600, Lewiston, ID 83501 2012-02-17
1306134077 Rowena Kathryn Jackson Counselor 531 Bryden Avenue, Lewiston, ID 83501 2011-07-15
1912290388 Staci Leanne Truby Massage Therapist 717 'd' Street, Lewiston, ID 83501 2011-05-18
1093040685 Sharie Ann Uhlorn Registered Nurse 1837 Alder Court, Lewiston, ID 83501 2009-10-15
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Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1215550108 Jasmine Dawn Hussey Social Worker 17 Cram Ave Apt 3, Lewiston, ME 04240-3750 2020-05-26
1124650106 Summer Overberg Social Worker 908 Idaho St, Lewiston, ID 83501-1937 2020-02-07
1922665173 Shana Wallace Social Worker 150 South Ave # 2, Lewiston, ME 04240-5759 2019-05-23
1407336746 Kelsey Wilcox Social Worker 37 Park St Ste 203, Lewiston, ME 04240-7195 2018-08-16
1003301680 Serenity Treatment LLC Social Worker 1229 Main St Ste 101, Lewiston, ID 83501-6901 2018-06-26
1053830299 Rebecca Baker Social Worker 37 Park St Ste 201, Lewiston, ME 04240-7196 2017-09-19
1043660343 Heath B Walters Social Worker 504 Main St Ste 470, Lewiston, ID 83501-1806 2016-06-16
1700253614 Eric Stephen Esty Social Worker 35 Westminster St, Lewiston, ME 04240-3531 2015-08-26
1205213857 Brandon Mcintosh Social Worker 523 1/2 Main St Ste 7, Lewiston, ID 83501-1870 2015-05-04
1285026229 Lauren Nichols Social Worker 1310 9th Ave, Lewiston, ID 83501-3104 2015-02-27
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Competitor

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City LEWISTON
Zip Code 83501

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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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