Healthcare Provider Details

I. General information

NPI: 1154824092
Provider Name (Legal Business Name): JOSEPH E WEIKERT LISW, LICDC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2018
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 S LIMESTONE ST
SPRINGFIELD OH
45505-1965
US

IV. Provider business mailing address

651 S LIMESTONE ST
SPRINGFIELD OH
45505-1965
US

V. Phone/Fax

Practice location:
  • Phone: 937-324-1111
  • Fax: 937-328-7257
Mailing address:
  • Phone: 937-324-1111
  • Fax: 937-525-4541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2607800
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.162578
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: