Healthcare Provider Details

I. General information

NPI: 1952859886
Provider Name (Legal Business Name): JOANN L WESTON M.A.,L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOANN L. WILSON MA, LPC

II. Dates (important events)

Enumeration Date: 09/20/2016
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N WASHINGTON ST STE 101
FARMINGTON MO
63640-1702
US

IV. Provider business mailing address

400 N WASHINGTON ST STE 101
FARMINGTON MO
63640-1702
US

V. Phone/Fax

Practice location:
  • Phone: 573-516-7904
  • Fax: 573-915-5039
Mailing address:
  • Phone: 573-516-7904
  • Fax: 573-915-5039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2014004873
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2014004873
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: