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General NPI Number Information
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NPI Number | 1043134885
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Entity Type | Individual
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Provider Name | NICHOLAS WEGMAN MA, T-LAC
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Gender | Male
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 14300 N NORTHSIGHT BLVD STE 110
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3673
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Country | US
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Telephone | 818-924-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 14545 N FRANK LLOYD WRIGHT BLVD UNIT 1061
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-8816
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Country | US
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Telephone | 406-239-3391
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LAC-08494T
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License Number State | AZ
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