Provider Demographics
NPI:1326002015
Name:WEHRMAN, ROSANNA XIMENES (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROSANNA
Middle Name:XIMENES
Last Name:WEHRMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 LEWIS LN
Mailing Address - Street 2:PAVILION 1 SUITE 109
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-9378
Mailing Address - Country:US
Mailing Address - Phone:903-782-9500
Mailing Address - Fax:903-782-9550
Practice Address - Street 1:2850 LEWIS LN
Practice Address - Street 2:PAVILION 1 SUITE 109
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75462-2019
Practice Address - Country:US
Practice Address - Phone:903-782-9500
Practice Address - Fax:903-782-9550
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK154101YA0400X
TX095551041C0700X
OK24271041C0700X
TX4515101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX108123402Medicaid
TX00S02PMedicare ID - Type Unspecified