Provider Demographics
NPI:1851967855
Name:WEIMER, MADISON
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:WEIMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 LEHIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-2007
Mailing Address - Country:US
Mailing Address - Phone:724-884-5499
Mailing Address - Fax:
Practice Address - Street 1:11279 PERRY HWY
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9381
Practice Address - Country:US
Practice Address - Phone:724-934-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor